Individual provider Active NPI

William Ingram Powell IV, F.N.P.

  • Family Nurse Practitioner
  • Chapel Hill, NC
National Provider Identifier
1497898597
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
79098 Issued in NC
Practice address
1728 Fordham Blvd
151 Rams Plaza
Chapel Hill, NC 27514-2397
Phone
(919) 968-1985
Fax
(919) 942-0038
NPI assigned
Feb 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 79098 NC Primary

Addresses

Primary practice location

1728 Fordham Blvd
151 Rams Plaza
Chapel Hill, NC 27514-2397

Mailing address

1728 Fordham Blvd
151 Rams Plaza
Chapel Hill, NC 27514-2397
Phone (919) 968-1985

Other identifiers 1

IdentifierTypeStateIssuer
MP011213OtherNCNC MEDICAL BOARD REGISTRA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
79098NCMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1497898597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1728 FORDHAM BLVD",
            "address_2": "151 RAMS PLAZA",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275142397",
            "telephone_number": "919-968-1985",
            "fax_number": "919-942-0038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1728 FORDHAM BLVD",
            "address_2": "151 RAMS PLAZA",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275142397",
            "telephone_number": "919-968-1985",
            "fax_number": "919-942-0038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWELL",
        "first_name": "WILLIAM",
        "middle_name": "INGRAM",
        "name_suffix": "IV",
        "credential": "F.N.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-15",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "79098",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC MEDICAL BOARD REGISTRA",
            "identifier": "MP011213",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chapel Hill, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.