Individual provider Active NPI

William Wesley Lawrence Jr., M.D.

  • Pediatrics Physician
  • Durham, NC
National Provider Identifier
1366632879
Registry record updated Jan 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
9700630 Issued in NC
Practice address
2609 N Duke St
Suite 1000
Durham, NC 27704-3048
Phone
(919) 220-4000
NPI assigned
Jul 31, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 9700630 NC Primary

Addresses

Primary practice location

2609 N Duke St
Suite 1000
Durham, NC 27704-3048

Mailing address

2501 Mail Service Ctr
NC Division of Medical Assistance
Raleigh, NC 27699-2500
Phone (919) 855-4100

Other identifiers 1

IdentifierTypeStateIssuer
5907790MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
630NCMDAcupuncturist
9700630NCMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1185840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231113600000",
    "number": "1366632879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 MAIL SERVICE CTR",
            "address_2": "NC DIVISION OF MEDICAL ASSISTANCE",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276992500",
            "telephone_number": "919-855-4100",
            "fax_number": "919-733-6608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2609 N DUKE ST",
            "address_2": "SUITE 1000",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277043048",
            "telephone_number": "919-220-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWRENCE",
        "first_name": "WILLIAM",
        "middle_name": "WESLEY",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-31",
        "last_updated": "2009-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "9700630",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5907790",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.