NPIMap

Individual provider Active NPI

Rahel Hailemichael Woldemariam, MD

  • Family Medicine Physician
  • Mint Hill, NC
National Provider Identifier
1295255289
Registry record updated Sep 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2003-02607 Issued in NC
Practice address
11300 Cresthill Dr Ste 100
Mint Hill, NC 28227-7992
Phone
(980) 302-3550
Fax
(980) 302-3551
NPI assigned
Jun 21, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 04-43491 KS
General Practice Physician 208D00000X 32831 PR
Family Medicine Physician 207Q00000X 2003-02607 NC Primary

Addresses

Primary practice location

11300 Cresthill Dr Ste 100
Mint Hill, NC 28227-7992

Mailing address

11300 Cresthill Dr Ste 100
Mint Hill, NC 28227-7992

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240712003896 NC Practitioner - Family Practice 9335567254 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

10810 Mallard Creek Rd
Charlotte, NC 28262-9786
Phone (704) 510-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2003-02607NCMDFamily Medicine Physician
32831PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC CurrentSince Jul 29, 2024 Accepting new patients
Stanton County Hospital Current Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Jul 29, 2024 Accepting new patients
Stanton County Hospital Current Accepting new patients

Locations

10810 Mallard Creek Rd
Charlotte, NC 28262
Phone (704) 510-8000

11300 Cresthill Dr
Ste 100
Mint Hill, NC 28227
Phone (980) 302-3550

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

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

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/stanton-86bf40ec
  • Direct secure messaging: rwoldemariam1595912@direct.novanthealth.org

Organizations & group practices 5

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1498003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726185600000",
    "number": "1295255289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11300 CRESTHILL DR STE 100",
            "city": "MINT HILL",
            "state": "NC",
            "postal_code": "282277992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11300 CRESTHILL DR STE 100",
            "city": "MINT HILL",
            "state": "NC",
            "postal_code": "282277992",
            "telephone_number": "980-302-3550",
            "fax_number": "980-302-3551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLDEMARIAM",
        "first_name": "RAHEL",
        "middle_name": "HAILEMICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-21",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "04-43491",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "32831",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2003-02607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mint Hill, NC

Sources for this page

Verify at the official NPI Registry.