Active NPI
Gustav C Wilde, M.D.
- Family Medicine Physician
- Franklin, NC
National Provider Identifier
1356395081
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 32974
- Practice address
- 161 Iotla Street
Franklin, NC 28734 - Phone
- (828) 369-4244
- Fax
- (828) 349-6767
- NPI assigned
- May 19, 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 32974 | NC | Primary |
Addresses
Primary practice location
161 Iotla Street
Franklin, NC 28734
Mailing address
161 Iotla Street
Franklin, NC 28734
Phone (828) 421-0460
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 51937 | Other | NC | MEDCOST |
| 8987403 | Medicaid | NC | |
| 87403 | Other | NC | BCBSNC |
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Franklin Family Practice PA | Family Medicine | Current | Accepting new patients |
Locations
161 Iotla St
Franklin, NC 28734
Phone (828) 306-4407
Interoperability endpoints
- gustav.wilde.1@16762.direct.athenahealth.com
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Franklin, NC
- NPI 1427000652
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1524614400000",
"number": "1356395081",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "161 IOTLA STREET",
"city": "FRANKLIN",
"state": "NC",
"postal_code": "28734",
"telephone_number": "828-421-0460",
"fax_number": "828-349-6767"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "161 IOTLA STREET",
"city": "FRANKLIN",
"state": "NC",
"postal_code": "28734",
"telephone_number": "828-369-4244",
"fax_number": "828-349-6767"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILDE",
"first_name": "GUSTAV",
"middle_name": "C",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-19",
"last_updated": "2018-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NC",
"license": "32974",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDCOST",
"identifier": "51937",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8987403",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSNC",
"identifier": "87403",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Franklin, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2018; 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.