NPIMap

Individual provider Active NPI

Mark Robert Weiser, MD

  • Family Medicine Physician
  • Lexington, NC
National Provider Identifier
1487621249
Registry record updated Nov 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
38460 Issued in NC
Practice address
110 W Medical Park Dr
Lexington, NC 27292-6773
Phone
(336) 248-8692
Fax
(336) 249-7348
NPI assigned
Mar 1, 2006
Last updated
Nov 10, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 38460 NC Primary

Addresses

Primary practice location

110 W Medical Park Dr
Lexington, NC 27292-6773

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other identifiers 1

IdentifierTypeStateIssuer
8986369MedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mweiser16533@direct.novanthealth.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031216000414 NC Practitioner - Family Practice 5991602161 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
West Virginia University School of Medicine, 1983
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)

4705 S Hwy 150
Suite Bandc
Lexington, NC 27295-5203
Phone (336) 481-1780

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Jun 29, 2019 Accepting new patients
Novant Health Medical Group, LLC Family Medicine CurrentSince Jun 29, 2019 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

10810 Mallard Creek Rd
Charlotte, NC 28262
Phone (704) 510-8000

110 W Medical Park Dr
Lexington, NC 27292
Phone (336) 248-8692

4705 S Highway 150
Ste Bc
Lexington, NC 27295
Phone (336) 481-1780

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

175 Kimel Park Dr
Ste 100
Winston Salem, NC 27103
Phone (336) 277-1811

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

Interoperability endpoints

  • Direct secure messaging: mweiser16533@direct.novanthealth.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668038400000",
    "number": "1487621249",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 W MEDICAL PARK DR",
            "city": "LEXINGTON",
            "state": "NC",
            "postal_code": "272926773",
            "telephone_number": "336-248-8692",
            "fax_number": "336-249-7348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISER",
        "first_name": "MARK",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-01",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "38460",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8986369",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mweiser16533@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "110 W Medical Park Dr",
            "city": "Lexington",
            "state": "NC",
            "country_code": "US",
            "postal_code": "272926773",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lexington, NC

Sources for this page

Verify at the official NPI Registry.