Individual provider Active NPI

David Chamberlayne Wilde Jr., MD

  • Otolaryngology Physician
  • Charleston, SC
National Provider Identifier
1477015246
Registry record updated Jul 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
MD94498 Issued in SC
Practice address
171 Ashley Ave
Charleston, SC 29425-0100
Phone
(432) 792-1414
NPI assigned
Apr 2, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X TX
Otolaryngology Physician 207Y00000X MD94498 SC Primary

Addresses

Primary practice location

171 Ashley Ave
Charleston, SC 29425-0100

Mailing address

171 Ashley Ave
Charleston, SC 29425-0100
Phone (432) 792-1414

Other practice location 1

6720 Bertner Ave
Houston, TX 77030-2604
Phone (832) 355-1000

Other practice location 2

6621 Fannin St
Houston, TX 77030-2358
Phone (832) 824-1000

Other practice location 3

2002 Holcombe Blvd
Houston, TX 77030-4211
Phone (713) 791-1414

Other practice location 4

1504 Ben Taub Loop
Houston, TX 77030
Phone (713) 873-2000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.musc.edu Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20250916000032 SC Practitioner - Otolaryngology 7719481647 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

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

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD94498SCMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Associates of the Medical University of South Carol Current Accepting new patients
University Medical Associates of the Medical University of South Carol CurrentSince Jul 28, 2025 Accepting new patients

Locations

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

Interoperability endpoints

  • Direct secure messaging: dwilde538078@direct.musc.edu

Organizations & group practices 2

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": "1554163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753228800000",
    "number": "1477015246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171 ASHLEY AVE",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294250100",
            "telephone_number": "432-792-1414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 ASHLEY AVE",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294250100",
            "telephone_number": "432-792-1414"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6720 Bertner Ave",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770302604",
            "country_code": "US",
            "telephone_number": "832-355-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6621 Fannin St",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770302358",
            "country_code": "US",
            "telephone_number": "832-824-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2002 Holcombe Blvd",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770304211",
            "country_code": "US",
            "telephone_number": "713-791-1414",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1504 Ben Taub Loop",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "77030",
            "country_code": "US",
            "telephone_number": "713-873-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILDE",
        "first_name": "DAVID",
        "middle_name": "CHAMBERLAYNE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-02",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "SC",
            "license": "MD94498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.musc.edu",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "171 Ashley Ave",
            "city": "Charleston",
            "state": "SC",
            "country_code": "US",
            "postal_code": "294250100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.