NPIMap

Organization Active NPI

Wilmington Health PLLC

  • Multi-Specialty Clinic/Center
  • Wilmington, NC
National Provider Identifier
1215593819
Registry record updated Feb 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
WILMINGTON HEALTH PLLC
Practice address
1811 Tiburon Dr
Wilmington, NC 28403-6254
Phone
(910) 341-3300
Fax
(910) 251-2067
NPI assigned
May 20, 2019
Last updated
Feb 2, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2023

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

Authorized official

Name
Jeanette Loveless
Title
Cbo Director
Phone
(910) 796-7730

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU Primary

Addresses

Primary practice location

1811 Tiburon Dr
Wilmington, NC 28403-6254

Mailing address

1202 Medical Center Dr
Wilmington, NC 28401-7307
Phone (910) 617-6705

Other names 1

  • Wilmington Health at LOB Other name

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D2168119Wilmington Health (Tiburon)1811 Tiburon Drive, Wilmington, NC 28403Certificate of waiverJun 20, 2027

National Provider Directory

National Provider Directory
Tax ID family
Wha Medical Clinic PLLC8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1811 Tiburon Dr
Wilmington, NC 28403

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1558310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675296000000",
    "number": "1215593819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 MEDICAL CENTER DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017307",
            "telephone_number": "910-617-6705",
            "fax_number": "910-431-4048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1811 TIBURON DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284036254",
            "telephone_number": "910-341-3300",
            "fax_number": "910-251-2067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILMINGTON HEALTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-20",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A",
        "authorized_official_last_name": "LOVELESS",
        "authorized_official_first_name": "JEANETTE",
        "authorized_official_title_or_position": "CBO DIRECTOR",
        "authorized_official_telephone_number": "910-796-7730"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wilmington Health at LOB",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Wilmington Health at LOB",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.