Active NPI
Nicole Wilde, M.D.
- Hospitalist Physician
- Raleigh, NC
National Provider Identifier
1255585246
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospitalist Physician
- License
- 2011-00689
- Practice address
- 4420 Lake Boone TRL
Rex Hospital
Raleigh, NC 27607-7505 - Phone
- (919) 784-3175
- Fax
- (919) 784-3440
- NPI assigned
- Nov 4, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospitalist Physician | 208M00000X | 2011-00689 | NC | Primary |
Addresses
Primary practice location
4420 Lake Boone TRL
Rex Hospital
Raleigh, NC 27607-7505
Mailing address
4420 Lake Boone Trail
Rex Hospital
Raleigh, NC 27607
Phone (919) 784-3100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2011-00689 | NC | MD | Hospitalist Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rex Hospital, Inc. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Nutrition Education Nutritionist
- Raleigh, NC
- NPI 1821472572
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1225756800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1336694400000",
"number": "1255585246",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4420 LAKE BOONE TRAIL",
"address_2": "REX HOSPITAL",
"city": "RALEIGH",
"state": "NC",
"postal_code": "27607",
"telephone_number": "919-784-3100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4420 LAKE BOONE TRL",
"address_2": "REX HOSPITAL",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276077505",
"telephone_number": "919-784-3175",
"fax_number": "919-784-3440"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILDE",
"first_name": "NICOLE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-11-04",
"last_updated": "2012-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "NC",
"license": "2011-00689",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.