Individual provider Active NPI

Wansi Bernadette Zedom, MD

  • Hospitalist Physician
  • Matthews, NC
National Provider Identifier
1427369701
Registry record updated Oct 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
2013-02013 Issued in NC
Practice address
1500 Matthews Township Pkwy
Matthews, NC 28105-4656
Phone
(704) 384-5416
Fax
(704) 384-5992
NPI assigned
Jul 1, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 9407564 KS
Internal Medicine Physician 207R00000X 2013-02013 NC
Hospitalist Physician 208M00000X 2013-02013 NC Primary

Addresses

Primary practice location

1500 Matthews Township Pkwy
Matthews, NC 28105-4656

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 384-9740

Other practice location 1

2525 Court Dr
Gastonia, NC 28054-2140
Phone (704) 834-2000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address wzedom438667@direct.novanthealth.org

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140125000195 NC Practitioner - Internal Medicine 2961630751 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

1500 Matthews Township Pkwy
Matthews, NC 28105-4656
Phone (704) 384-6478

Hospital & facility affiliations

  • Novant Health Matthews Medical Center Hospital, Matthews, NC, CCN 340171
  • Novant Health Ballantyne Medical Center Hospital, Charlotte, NC, CCN 340195
  • Novant Health Presbyterian Medical Center Hospital, Charlotte, NC, CCN 340053

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9407564KSMDInternal Medicine Physician
2013-02013NCMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Caromont Medical Group Inc Internal Medicine Current Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC Internal Medicine CurrentSince Jul 9, 2017 Accepting new patients
Novant Health Matthews Medical Center LLC CurrentSince Jan 27, 2024 Accepting new patients
Caromont Medical Group Inc CurrentSince Oct 1, 2013 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Jul 9, 2017 Accepting new patients
Caromont Medical Group, Inc. Hospitalist CurrentSince Oct 1, 2013 Accepting new patients

Locations

1901 Randolph Rd
Charlotte, NC 28207
Phone (704) 316-2000

2525 Court Dr
Gastonia, NC 28054
Phone (704) 834-2662

660 Summit Crossing Pl
Ste 301
Gastonia, NC 28054
Phone (704) 854-8799

1500 Matthews Township Pkwy
Matthews, NC 28105
Phone (704) 384-6500

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Interoperability endpoints

  • Direct secure messaging: wzedom438667@direct.novanthealth.org

Organizations & group practices 7

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 6

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": "1277942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603756800000",
    "number": "1427369701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "704-384-9740",
            "fax_number": "704-384-9565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 MATTHEWS TOWNSHIP PKWY",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281054656",
            "telephone_number": "704-384-5416",
            "fax_number": "704-384-5992"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2525 Court Dr",
            "address_purpose": "LOCATION",
            "city": "Gastonia",
            "state": "NC",
            "postal_code": "280542140",
            "country_code": "US",
            "telephone_number": "704-834-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZEDOM",
        "first_name": "WANSI",
        "middle_name": "BERNADETTE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-01",
        "last_updated": "2020-10-27",
        "certification_date": "2020-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KS",
            "license": "9407564",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2013-02013",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NC",
            "license": "2013-02013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wzedom438667@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "2525 Court Dr",
            "city": "Gastonia",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280542140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Matthews, NC

Sources for this page

Verify at the official NPI Registry.