Active NPI
Randal K Detwiler, MD
- Nephrology Physician
- Chapel Hill, NC
National Provider Identifier
1306911177
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- Practice address
- 101 Manning Dr
Chapel Hill, NC 27599-0001 - Phone
- (919) 966-8596
- Fax
- (919) 843-5515
- NPI assigned
- Nov 21, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | NC | Primary |
Addresses
Primary practice location
101 Manning Dr
Chapel Hill, NC 27599-0001
Mailing address
143 W Franklin St
Chapel Hill, NC 27516-2539
Phone (919) 966-8596
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 89132GW | Medicaid | NC |
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
Care Compare profile
Medicare Care Compare- Specialty
- Nephrology
- Education
- Ohio State University College of Medicine, 1986
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
100 Eastowne Dr
Chapel Hill, NC 27514-2286
Phone (984) 215-5556
101 Manning Dr
Chapel Hill, NC 27514-4220
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0000-33028 | NC | MD | Nephrology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of North Carolina at Chapel Hill | Current | Accepting new patients | |
| University of North Carolina at Chapel Hill | Current | Accepting new patients | |
| Park Ophthalmology | Past | Accepting new patients |
Locations
102 Mason Farm Rd
Chapel Hill, NC 27599
Phone (919) 966-1459
101 Manning Dr
Chapel Hill, NC 27514
Phone (984) 974-1485
100 Eastowne Dr
Fl 14
Chapel Hill, NC 27514
Phone (984) 215-5556
1301 Central Dr
Sanford, NC 27330
Phone (919) 718-9512
Interoperability endpoints
- rdetwiler31501@direct.unc.nchie.net
Organizations & group practices 3
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.
-
- Anesthesiology Physician
- Chapel Hill, NC
- NPI 1780669200
-
- Clinic/Center
- Chapel Hill, NC
- NPI 1285689299
-
- Ophthalmology Physician
- Durham, NC
- NPI 1619150141
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Obesity Medicine (Internal Medicine) Physician
- Pinehurst, NC
- NPI 1740463967
Hospital
-
- General Acute Care Hospital
- Pinehurst, NC
- NPI 1740208081
-
- General Acute Care Hospital
- Rocky Mount, NC
- NPI 1619969219
-
- General Acute Care Hospital
- Raleigh, NC
- NPI 1497797088
-
- General Acute Care Hospital
- Lumberton, NC
- NPI 1427030774
-
- General Acute Care Hospital
- Chapel Hill, NC
- NPI 1932208576
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164067200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1306911177",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "143 W FRANKLIN ST",
"city": "CHAPEL HILL",
"state": "NC",
"postal_code": "275162539",
"telephone_number": "919-966-8596",
"fax_number": "919-843-5515"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 MANNING DR",
"city": "CHAPEL HILL",
"state": "NC",
"postal_code": "275990001",
"telephone_number": "919-966-8596",
"fax_number": "919-843-5515"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DETWILER",
"first_name": "RANDAL",
"middle_name": "K",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "NC",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "89132GW",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chapel Hill, 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.
- 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.