Individual provider Active NPI

William Wayne Cheatham Jr., D.O.

  • Family Medicine Physician
  • Raleigh, NC
National Provider Identifier
1639154198
Registry record updated May 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2014-01480 Issued in NC
Practice address
6021 Poyner Village Pkwy Ste 101
Raleigh, NC 27616-3398
Phone
(984) 215-4940
Fax
(984) 215-4945
NPI assigned
Dec 7, 2005
Last updated
May 6, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2021

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2014-01480 NC Primary
Adolescent Medicine (Family Medicine) Physician 207QA0000X 2014-01480 NC
Adult Medicine Physician 207QA0505X 2014-01480 NC
Geriatric Medicine (Family Medicine) Physician 207QG0300X 2014-01480 NC
Sports Medicine (Family Medicine) Physician 207QS0010X 2014-01480 NC

Addresses

Primary practice location

6021 Poyner Village Pkwy Ste 101
Raleigh, NC 27616-3398

Mailing address

2000 Perimeter Park Dr Ste 200
Morrisville, NC 27560-8442
Phone (984) 215-4111

Other identifiers 1

IdentifierTypeStateIssuer
NN6215AOtherNCMEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address wcheatham585736@direct.UNC.nchie.net Direct

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20190327001927 NC Practitioner - Family Practice 5890767255 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Unc Physicians Network LLCGroup PAC ID 5496940546, 985 clinicians

Practice addresses (Care Compare)

6021 Poyner Village Pkwy
Suite 101
Raleigh, NC 27616-3398
Phone (984) 215-4940

940 Martin Luther King Jr Blvd
Chapel Hill, NC 27514-2601
Phone (919) 942-5123

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Unc Physicians Network, LLC Family Medicine CurrentSince Nov 1, 2019 Accepting new patients
Unc Physicians Network LLC Family Medicine CurrentSince Nov 1, 2019 Accepting new patients
Unc Physicians Network LLC Family Medicine Current Accepting new patients
Primary Care Psychology, PLC CurrentSince Jul 26, 2004 Accepting new patients
Medical Specialists of the Palm Beaches Inc Past Accepting new patients
Horn & Bache, P.a. Family Medicine Past Accepting new patients

Locations

1990 N Federal Hwy
Ste C
Pompano Beach, FL 33062
Phone (954) 788-9399

940 Martin Luther King Jr Blvd
Chapel Hill, NC 27514
Phone (919) 942-5123

6905 Knightdale Blvd
Ste 106
Knightdale, NC 27545
Phone (919) 261-8760

2000 Perimeter Park Dr
Ste 200
Morrisville, NC 27560
Phone (800) 594-8624

10208 Cerny St
Ste 110
Raleigh, NC 27617
Phone (984) 215-4590

11200 Governor Manly Way
Ste 205
Raleigh, NC 27614
Phone (919) 570-5900

4551 New Bern Ave
Ste 100
Raleigh, NC 27610
Phone (984) 215-4950

6021 Poyner Village Pkwy
Ste 101
Raleigh, NC 27616
Phone (919) 570-7590

Interoperability endpoints

  • Direct secure messaging: wcheatham585736@direct.unc.nchie.net

Organizations & group practices 6

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 1

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": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620259200000",
    "number": "1639154198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 PERIMETER PARK DR STE 200",
            "city": "MORRISVILLE",
            "state": "NC",
            "postal_code": "275608442",
            "telephone_number": "984-215-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6021 POYNER VILLAGE PKWY STE 101",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276163398",
            "telephone_number": "984-215-4940",
            "fax_number": "984-215-4945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEATHAM",
        "first_name": "WILLIAM",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-07",
        "last_updated": "2021-05-06",
        "certification_date": "2021-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2014-01480",
            "primary": true
        },
        {
            "code": "207QA0000X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adolescent Medicine",
            "state": "NC",
            "license": "2014-01480",
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "NC",
            "license": "2014-01480",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "NC",
            "license": "2014-01480",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "NC",
            "license": "2014-01480",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "NN6215A",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wcheatham585736@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "6021 Poyner Village Pkwy Ste 101",
            "city": "Raleigh",
            "state": "NC",
            "country_code": "US",
            "postal_code": "276163398",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.