Denise Wibran Sponseller, MPAS, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-04822 Issued in NC

Practice address

811 US 70 Hwy W
Garner, NC 27529-2541

Phone

(919) 235-6565

NPI assigned

Jan 27, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Ellen Denise Wibran Former name

Electronic endpoints 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

University of Texas Medical Branch at Galveston, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wakemed Specialists Group LLCGroup PAC ID 2466788377, 868 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wakemed, Raleigh Campus Hospital, Raleigh, NC, CCN 340069

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ewibran243927@directhisp.wakemed.org

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.

• Wakemed Specialists Group, LLC

  • Cardiovascular Disease Physician
  • Raleigh, NC
  • NPI 1588227839

  NC

  Medicare reassignment Care Compare group
• Wakemed Specialists Group LLC

  • Cardiac Rehabilitation Registered Nurse
  • Raleigh, NC
  • NPI 1063304228
  NPD
• Wakemed Specialists Group, LLC

  • Clinical Cardiac Electrophysiology Physician
  • Raleigh, NC
  • NPI 1720643174
  NPD
• Rex Hospital Inc

  • Cardiovascular Disease Physician
  • Raleigh, NC
  • NPI 1972939643
  NPD (past)

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

• Wakemed

  • Psychiatric Hospital Unit
  • Raleigh, NC
  • NPI 1780446302

  Hospital

  Care Compare affiliation
• Wakemed

  • General Acute Care Hospital
  • Raleigh, NC
  • NPI 1972579837

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1390780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618272000000",
    "number": "1306269477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2920 HIGHWOODS BLVD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276040010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 US 70 HWY W",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275292541",
            "telephone_number": "919-235-6565"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1714 Highway 17 S",
            "address_purpose": "LOCATION",
            "city": "North Myrtle Beach",
            "state": "SC",
            "postal_code": "295824041",
            "country_code": "US",
            "telephone_number": "843-361-0705",
            "fax_number": "843-361-4045",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4414 Lake Boone Trl Ste 108",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "27607",
            "country_code": "US",
            "telephone_number": "919-784-2300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "212 Ashville Ave Ste 10",
            "address_purpose": "LOCATION",
            "city": "Cary",
            "state": "NC",
            "postal_code": "27518",
            "country_code": "US",
            "telephone_number": "919-859-1136",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "212 Ashville Ave Ste 10",
            "address_purpose": "LOCATION",
            "city": "Cary",
            "state": "NC",
            "postal_code": "27518",
            "country_code": "US",
            "telephone_number": "919-859-1136",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPONSELLER",
        "first_name": "DENISE",
        "middle_name": "WIBRAN",
        "credential": "MPAS, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-27",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "MPA.2046",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-04822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ewibran243927@directHISP.wakemed.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "xml",
            "address_1": "811 US 70 Hwy W",
            "city": "Garner",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275292541",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ELLEN",
            "last_name": "WIBRAN",
            "middle_name": "DENISE",
            "credential": "MPAS, PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Speak Advantage
• James Spears, OWNER,OPERATOR
• Varnar Spencer, CRNA
• Alexander Spinoccia, DC
• David E Spivey Jr., MD
• Jasmine Necole Spooner, PHARMD
• Liam Kevin Spratt
• Matthew Thomas Sproul, M.D.
• Gwenetta La'Shawn Spruill
• Eryn Louise Steere, PHARMD

• All providers in Garner, NC
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.