NPIMap

Individual provider Active NPI

Ann Wyttenbach, MD

  • Family Medicine Physician
  • Charlotte, NC
National Provider Identifier
1578616918
Registry record updated Feb 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
9600376 Issued in NC
Practice address
901 Jefferson Dr
Charlotte, NC 28270-5213
Phone
(704) 366-1215
NPI assigned
Jan 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2011

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 9600376 NC Primary

Addresses

Primary practice location

901 Jefferson Dr
Charlotte, NC 28270-5213

Mailing address

901 Jefferson Dr
Charlotte, NC 28270-5213
Phone (704) 366-1215

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
9600376NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Union Urgent Care LLC Family Medicine Past Accepting new patients
Carolinas Physicians Network Inc Family Medicine Past Accepting new patients
Carolinas Physicians Network Inc Family Medicine Past Accepting new patients
Carolinas Physicians Network Inc Family Medicine Past Accepting new patients
Carolinas Physicians Network Inc Past Accepting new patients
Carolinas Physicians Network Inc Family Medicine Past Accepting new patients
Carolinas Physicians Network Inc Family Medicine Past Accepting new patients
Carolinas Physicians Network Inc Family Medicine Past Accepting new patients
Union Urgent Care LLC Family Medicine Past Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297900800000",
    "number": "1578616918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 JEFFERSON DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282705213",
            "telephone_number": "704-366-1215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 JEFFERSON DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282705213",
            "telephone_number": "704-366-1215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYTTENBACH",
        "first_name": "ANN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-19",
        "last_updated": "2011-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "9600376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2011; 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.