William Blake Pemberton, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

2015-01934 Issued in NC

Practice address

1010 College St
Oxford, NC 27565-2507

Phone

(919) 690-3000

NPI assigned

May 2, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC, GA, MD3 enrollments

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 3

Specialty

Emergency Medicine

Education

University of North Carolina at Chapel Hill School of Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wake Emergency Physicians PAGroup PAC ID 9931002078, 269 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wakemed, Raleigh Campus Hospital, Raleigh, NC, CCN 340069
• Wakemed, Cary Hospital Hospital, Cary, NC, CCN 340173
• Granville Health Systems Hospital, Oxford, NC, CCN 340127

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
• Direct secure messaging: wpemberton14850@directhisp.wakemed.org

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.

• Wake Emergency Physicians PA

  • Emergency Medicine Physician
  • Raleigh, NC
  • NPI 1922063387
  Medicare reassignment Care Compare group NPD
• Privia Medical Group of Georgia LLC

  • Internal Medicine Physician
  • Fayetteville, GA
  • NPI 1013313857
  Medicare reassignment NPD
• Privia Medical Group, LLC

  • Internal Medicine Physician
  • Arlington, VA
  • NPI 1013042480

  MD

  Medicare reassignment
• Wake Emergency Physicians PA

  • Emergency Medicine Physician
  • Apex, NC
  • NPI 1043492853
  NPD
• Wake Emergency Physicians PA

  • Emergency Medicine Physician
  • Goldsboro, NC
  • NPI 1619758018
  NPD
• Privia Medical Group of Georgia LLC

  • Internal Medicine Physician
  • Savannah, GA
  • NPI 1356907273
  NPD
• Privia Medical Group, LLC

  • Internal Medicine Physician
  • Arlington, VA
  • NPI 1093251209
  NPD
• Wake Emergency Physicians PA

  • Emergency Medicine Physician
  • Cary, NC
  • NPI 1265923205
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Granville Health System

  • General Acute Care Hospital
  • Oxford, NC
  • NPI 1326061730
  Care Compare affiliation
• Wakemed

  • General Acute Care Hospital
  • Cary, NC
  • NPI 1114993086
  Care Compare affiliation
• Wakemed

  • Psychiatric Hospital Unit
  • Raleigh, NC
  • NPI 1780446302
  Care Compare affiliation
• Wakemed

  • General Acute Care Hospital
  • Raleigh, NC
  • NPI 1972579837
  Care Compare affiliation

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

{
    "created_epoch": "1367452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588636800000",
    "number": "1477998664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 TOWNE VILLAGE DR",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275138910",
            "telephone_number": "919-859-3373",
            "fax_number": "919-336-4363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 COLLEGE ST",
            "city": "OXFORD",
            "state": "NC",
            "postal_code": "275652507",
            "telephone_number": "919-690-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEMBERTON",
        "first_name": "WILLIAM",
        "middle_name": "BLAKE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-02",
        "last_updated": "2020-05-05",
        "certification_date": "2020-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME142310",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "2015-01934",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL MEDICARE",
            "identifier": "L2853",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robin R Palmer
• Evelyn L Parham, NP
• Debra Ann Parker, LCSW
• Jasmine Latisha Parker
• Vernita Harrington Parker, DIRECTOR
• Perfect Choice Home Care
• Perfect Foundation, Inc.
• Perioperative Specialists of North Carolina
• William Horace Perry, PT
• Anna Pevzner-Kalika, D.O

• Emergency Medicine Physician in Oxford, NC
• Providers in Oxford, NC by specialty
• Emergency Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.