Individual provider Active NPI

De Benjamin Winter III, M.D.

  • Emergency Medicine Physician
  • Wilmington, NC
National Provider Identifier
1205969953
Registry record updated Jul 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2011-00277 Issued in NC
Practice address
4402 Shipyard Blvd
Wilmington, NC 28403-6161
Phone
(302) 733-3904
NPI assigned
Mar 13, 2007
Last updated
Jul 11, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X C7-0003443 DE
Emergency Medicine Physician 207P00000X 2011-00277 NC Primary
Internal Medicine Physician 207R00000X C7-0003443 DE

Addresses

Primary practice location

4402 Shipyard Blvd
Wilmington, NC 28403-6161

Mailing address

1213 Verandah Way
Wilmington, NC 28411-9268

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110627000447 NC Practitioner - Emergency MedicinePractitioner - Internal Medicine 4587842398 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C7-0003443DEMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ecep II PA Emergency Medicine CurrentSince Jul 1, 2011 Accepting new patients
Novant Health Medical Group Coastal Region, LLC Internal Medicine CurrentSince Feb 4, 2024 Accepting new patients
NMG Health Services LLC CurrentSince Feb 4, 2024 Accepting new patients
Ecep II PA Emergency Medicine CurrentSince Jul 1, 2011 Accepting new patients
Novant Health Medical Group Coastal Region, LLC Current Accepting new patients
Pender Memorial Hospital, Incorporated Past Accepting new patients

Locations

507 E Fremont St
Burgaw, NC 28425
Phone (910) 259-5451

800 Jefferson St
Ste 112
Whiteville, NC 28472
Phone (910) 642-8164

151 Scotts Hill Medical Dr
Wilmington, NC 28411
Phone (910) 662-8440

2131 S 17th St
Wilmington, NC 28401
Phone (910) 342-3000

4402 Shipyard Blvd
Wilmington, NC 28403
Phone (910) 202-3363

5301 Wrightsville Ave
Wilmington, NC 28403
Phone (910) 452-8100

Interoperability endpoints

  • Direct secure messaging: dwinter1253416@direct.novanthealth.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310342400000",
    "number": "1205969953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1213 VERANDAH WAY",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284119268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4402 SHIPYARD BLVD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284036161",
            "telephone_number": "302-733-3904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINTER",
        "first_name": "DE",
        "middle_name": "BENJAMIN",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-13",
        "last_updated": "2011-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "DE",
            "license": "C7-0003443",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "2011-00277",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "DE",
            "license": "C7-0003443",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.