John Dwyer Powderly II, M.D.

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

200000939 Issued in NC

Practice address

9801 Kincey Ave
Suite 145
Huntersville, NC 28078-3110

Phone

(704) 947-6599

Fax

(704) 947-6597

NPI assigned

Jul 21, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Biocytics, Inc.

  • Clinical Medical Laboratory
  • Huntersville, NC
  • NPI 1649504192
  NPD (past) Authorized official
• Piedmont Oncology Specialists

  • Hematology & Oncology Physician
  • Monroe, NC
  • NPI 1619927316
  NPD (past)

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373414400000",
    "number": "1265453047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3547",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280703547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9801 KINCEY AVE",
            "address_2": "SUITE 145",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280783110",
            "telephone_number": "704-947-6599",
            "fax_number": "704-947-6597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWDERLY",
        "first_name": "JOHN",
        "middle_name": "DWYER",
        "name_suffix": "II",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2013-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NC",
            "license": "200000939",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "200000939",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "E2701",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS INDIVIDUAL NUMBER",
            "identifier": "12618",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8912618",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "4859724",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PIN",
            "identifier": "7413187",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "203016908",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carrie Jane Pitts
• Plohal Dermatology PLLC
• Regina Plohal, FNP
• Wendy Plunkett
• Deborah Ann Ponti, LPTA
• Taylor Powell
• Pranamixpt, LLC
• Premier Physical Therapy LLC
• Presbyterian Breast Center, LLC
• Presbyterian Breast Center, LLC

• Hematology & Oncology Physician in Huntersville, NC
• Providers in Huntersville, NC by specialty
• Hematology & Oncology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.