NPIMap

Individual provider Active NPI

Eric M Wallen, MD

  • Urology Physician
  • Chapel Hill, NC
National Provider Identifier
1386730729
Registry record updated Apr 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
T01873 Issued in NC
Practice address
101 Manning Dr
Chapel Hill, NC 27599-0001
Phone
(919) 966-8596
Fax
(919) 843-5515
NPI assigned
Oct 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X T01873 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

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ewallen12454@direct.unc.nchie.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110119000495 NC Practitioner - Urology 6800803453 Reassigns benefits to 2 organizations
I20241011002890 SC Practitioner - Urology 6800803453 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

171 Ashley Ave
Charleston, SC 29425-8908
Phone (843) 792-1414

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection16

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
T01873NCMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Unc Physicians Network LLC Urology CurrentSince Jun 9, 2024 Accepting new patients
Unc Physicians Network LLC Current Accepting new patients
University Medical Associates of the Medical University of South Carol Current Accepting new patients
Chatham Hospital, Inc. CurrentSince Oct 4, 2013 Accepting new patients
University Medical Associates of the Medical University of South Carol CurrentSince Sep 20, 2024 Accepting new patients

Locations

940 Martin Luther King Jr Blvd
Chapel Hill, NC 27514
Phone (919) 942-5123

101 Manning Dr
Ste 300
Chapel Hill, NC 27514
Phone (984) 215-5000

101 Manning Dr
Chapel Hill, NC 27514
Phone (984) 974-1485

701 Doctors Dr
Ste L
Kinston, NC 28501
Phone (252) 527-3043

5221 Paramount Pkwy
Ste 220
Morrisville, NC 27560
Phone (984) 215-4110

4420 Lake Boone Trl
Ste 100
Raleigh, NC 27607
Phone (984) 215-6950

475 Progress Blvd
Siler City, NC 27344
Phone (919) 799-4000

171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123

8992 University Blvd
North Charleston, SC 29406
Phone (843) 876-5555

Interoperability endpoints

  • Direct secure messaging: ewallen504600@direct.musc.edu
  • Direct secure messaging: ewallen12454@direct.unc.nchie.net

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 12

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617235200000",
    "number": "1386730729",
    "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": "WALLEN",
        "first_name": "ERIC",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2021-04-01",
        "certification_date": "2021-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NC",
            "license": "T01873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ewallen12454@direct.unc.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "101 Manning Dr",
            "city": "Chapel Hill",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275990001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chapel Hill, NC

Sources for this page

Verify at the official NPI Registry.