Active NPI
Stuart Yale Wernikoff, M.D.
- Dermatology Physician
- Charlotte, NC
National Provider Identifier
1285699066
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 28712
- Practice address
- 2015 Randolph Rd
Ste. 210
Charlotte, NC 28207-1200 - Phone
- (704) 333-8811
- Fax
- (704) 333-9504
- NPI assigned
- Apr 18, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 28712 | NC | Primary |
Addresses
Primary practice location
2015 Randolph Rd
Ste. 210
Charlotte, NC 28207-1200
Mailing address
2015 Randolph Rd
Ste. 210
Charlotte, NC 28207-1200
Phone (704) 333-8811
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100423000672 | NC | Practitioner - Dermatology | 2769519610 | Practice locations: Charlotte, NC |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145318400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1285699066",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2015 RANDOLPH RD",
"address_2": "STE. 210",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282071200",
"telephone_number": "704-333-8811",
"fax_number": "704-333-9504"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2015 RANDOLPH RD",
"address_2": "STE. 210",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282071200",
"telephone_number": "704-333-8811",
"fax_number": "704-333-9504"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WERNIKOFF",
"first_name": "STUART",
"middle_name": "YALE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-04-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "NC",
"license": "28712",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.