Individual provider Active NPI

Randall David Wilhoit IV, RN

  • Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1467961029
Registry record updated Jul 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5013068 Issued in NC
Practice address
22 S Greene St
Baltimore, MD 21201-1544
Phone
(410) 328-8667
NPI assigned
Sep 27, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5013068 NC Primary
Medical-Surgical Registered Nurse 163WM0705X R210020 MD
Acute Care Nurse Practitioner 363LA2100X R210020 MD

Addresses

Primary practice location

22 S Greene St
Baltimore, MD 21201-1544

Mailing address

2515 Guilford Ave
Baltimore, MD 21218-4619
Phone (864) 201-5927

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200721004207 NC Practitioner - Nurse Practitioner 4486913811 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

30 Choctaw St
Suite a
Asheville, NC 28801-4514
Phone (828) 213-1740

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.39 of 100Reported as apm
Quality
77.7
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
5013068NCMDNurse Practitioner
R210020MDMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mission Community Anesthesiology Specialists LLC CurrentSince Aug 31, 2020 Accepting new patients
Mission Health Community Multispecialty Providers, LLC CurrentSince Aug 31, 2020 Accepting new patients
Mission Community Anesthesiology Specialists LLC Past Accepting new patients

Locations

509 Biltmore Ave
Asheville, NC 28801
Phone (828) 213-2325

30 Choctaw St
Ste A
Asheville, NC 28801
Phone (828) 255-7733

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Interoperability endpoints

  • Direct secure messaging: rwilhoit503137@direct.umm.edu

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.

Hospital & facility affiliations 1

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": "1506470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595808000000",
    "number": "1467961029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2515 GUILFORD AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212184619",
            "telephone_number": "864-201-5927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011544",
            "telephone_number": "410-328-8667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILHOIT",
        "first_name": "RANDALL",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "name_suffix": "IV",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-09-27",
        "last_updated": "2020-07-27",
        "certification_date": "2020-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5013068",
            "primary": true
        },
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "MD",
            "license": "R210020",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MD",
            "license": "R210020",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.