NPIMap

Individual provider Active NPI

Walid Raouf Eltaraboulsi, MD

  • Pulmonary Disease Physician
  • Charlotte, NC
National Provider Identifier
1245491083
Registry record updated Oct 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
2011-01032 Issued in NC
Practice address
10320 Feld Farm LN Ste 300
Charlotte, NC 28210-8484
Phone
(980) 488-9870
Fax
(980) 488-9875
NPI assigned
Jun 24, 2008
Last updated
Oct 29, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2024

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Internal Medicine Physician 207R00000X 86883 SC
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 2011-01032 NC
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 86883 SC
Pulmonary Disease Physician 207RP1001X 2011-01032 NC Primary
Pulmonary Disease Physician 207RP1001X 86883 SC
Pulmonary Disease Physician 207RP1001X 207RP1001X NC

Addresses

Primary practice location

10320 Feld Farm LN Ste 300
Charlotte, NC 28210-8484

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other practice location 1

16817 Marvin Road
Charlotte, NC 28277
Phone (704) 495-6036

Other identifiers 3

IdentifierTypeStateIssuer
NC2170MedicaidSC
2011-01032OtherNCNC LICENSE
1245491083MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140828001254 NC Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 4082832381 Reassigns benefits to 3 organizations
I20220928002737 SC Practitioner - Internal Medicine 4082832381 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Hospitalist Services PCGroup PAC ID 3476855420, 301 clinicians
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians
The Presbyterian HospitalGroup PAC ID 1153231907, 412 clinicians

Practice addresses (Care Compare)

1000 Wellness Way
Fort Mill, SC 29715-7315
Phone (803) 329-1234

10320 Feld Farm LN
Suite 300
Charlotte, NC 28210-8484
Phone (980) 488-9870

125 Queens Rd
Charlotte, NC 28204-3215
Phone (980) 302-6450

809 82ND Pkwy
Myrtle Beach, SC 29572-4607
Phone (843) 692-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2011-01032NCMDCritical Care Medicine (Internal Medicine) Physician
86883SCMDCritical Care Medicine (Internal Medicine) Physician
207RP1001XNCMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Hospitalist Services PC Internal Medicine CurrentSince Oct 1, 2022 Accepting new patients
The Presbyterian Hospital Internal Medicine Current Accepting new patients
Novant Health Medical Group, LLC Pulmonary Disease CurrentSince Oct 1, 2024 Accepting new patients
The Presbyterian Hospital CurrentSince Jul 14, 2025 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Oct 1, 2024 Accepting new patients
Moses Cone Medical Services, Inc. Internal Medicine CurrentSince Nov 1, 2019 Accepting new patients
Moses Cone Medical Services, Inc. CurrentSince Nov 1, 2019 Accepting new patients
The Presbyterian Hospital Internal Medicine CurrentSince Jul 14, 2025 Accepting new patients
Tryon Medical Partners, PLLC Internal Medicine CurrentSince Sep 1, 2018 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

10320 Feld Farm Ln
Ste 300
Charlotte, NC 28210
Phone (704) 541-0925

125 Queens Rd
Charlotte, NC 28204
Phone (704) 384-5043

125 Queens Rd
Ste 430
Charlotte, NC 28204
Phone (980) 302-6300

16817 Marvin Rd
Charlotte, NC 28277
Phone (704) 275-3256

201 Queens Rd
Charlotte, NC 28204
Phone (704) 316-5285

335 N Caswell Rd
Charlotte, NC 28204
Phone (704) 384-7390

5950 Fairview Rd
Ste 330
Charlotte, NC 28210

5960 Fairview Rd
Ste 500
Charlotte, NC 28210

6324 Fairview Rd
Ste 330
Charlotte, NC 28210
Phone (704) 316-1950

1126 N Church St
Ste 300
Greensboro, NC 27401
Phone (336) 547-1700

520 N Elam Ave
Greensboro, NC 27403
Phone (336) 475-7148

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

940 Golf House Ct E
Whitsett, NC 27377
Phone (336) 449-9848

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

809 82nd Pkwy
Myrtle Beach, SC 29572
Phone (843) 291-7182

Interoperability endpoints

  • Direct secure messaging: weltaraboulsi657600@direct.novanthealth.org

Organizations & group practices 11

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.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1214265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1245491083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10320 FELD FARM LN STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282108484",
            "telephone_number": "980-488-9870",
            "fax_number": "980-488-9875"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16817 Marvin Road",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "28277",
            "country_code": "US",
            "telephone_number": "704-495-6036",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELTARABOULSI",
        "first_name": "WALID",
        "middle_name": "RAOUF",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-24",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "86883",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NC",
            "license": "2011-01032",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "SC",
            "license": "86883",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NC",
            "license": "2011-01032",
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "SC",
            "license": "86883",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NC",
            "license": "207RP1001X",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NC2170",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC LICENSE",
            "identifier": "2011-01032",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1245491083",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.