Clinton Dennis Wilburn, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

26411 Issued in NC

Practice address

5085 Morganton Rd
Suite100
Fayetteville, NC 28314-1523

Phone

(910) 864-1503

Fax

(910) 864-3747

NPI assigned

Mar 17, 2010

Last updated

Aug 18, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Cumberland Medical Associates, PC

  • Internal Medicine Physician
  • Fayetteville, NC
  • NPI 1801945118
  Medicare reassignment NPD

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

{
    "created_epoch": "1268784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282089600000",
    "number": "1518281773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5085 MORGANTON RD",
            "address_2": "SUITE100",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283141523",
            "telephone_number": "910-864-1503",
            "fax_number": "910-864-3747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5085 MORGANTON RD",
            "address_2": "SUITE100",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283141523",
            "telephone_number": "910-864-1503",
            "fax_number": "910-864-3747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILBURN",
        "first_name": "CLINTON",
        "middle_name": "DENNIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-03-17",
        "last_updated": "2010-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "26411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna Marie Wiener, PH.D.
• Kimberly Wiest, CRNA
• Shannon S Wiggins, LCSW
• William James Wiggs Jr., MD
• Erik Wiglama, D.O.
• Madison Blair Wilcox, OTR/L
• Peter Nelson Wildeboer, DO
• Marisa Wilder
• Grant Douglas Wiles, D.D.S
• Kimberly D Wiley

• Family Medicine Physician in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.