Wilmington Internal Medicine PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

85716 Issued in NC

Legal business name

WILMINGTON INTERNAL MEDICINE PA

Practice address

2215 Canterwood Dr
Wilmington, NC 28401-7301

Phone

(910) 762-4600

Fax

(910) 762-9483

NPI assigned

Mar 12, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Wendy Michelle Young

Title

Practice Manager

Phone

(910) 762-4600

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/5032/brand/1/csg/1/fhir/r4

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ian Foxall., M.D

  • Internal Medicine Physician
  • Wilmington, NC
  • NPI 1528008109
  Medicare reassignment Care Compare group NPD
• Emily Marja Rhoades, FNP

  • Nurse Practitioner
  • Wilmington, NC
  • NPI 1205529047

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Kimberly J Salene, M.D.

  • Internal Medicine Physician
  • Wilmington, NC
  • NPI 1124139373
  Medicare reassignment Care Compare group NPD
• Frank Alan Snyder, MD

  • Internal Medicine Physician
  • Wilmington, NC
  • NPI 1770563314
  Medicare reassignment Care Compare group NPD
• Mackensie Grant De la Roca, FNP

  • Family Nurse Practitioner
  • Forest City, NC
  • NPI 1134720766
  Medicare reassignment NPD
• Shannon Boney Mathis, NP-C

  • Nurse Practitioner
  • Wilmington, NC
  • NPI 1013472232
  Medicare reassignment NPD
• Mojgan Jones, PA-C

  • Medical Physician Assistant
  • Wilmington, NC
  • NPI 1801838644
  Medicare reassignment
• Boyan A Georgiev, MD

  • Internal Medicine Physician
  • Wilmington, NC
  • NPI 1063457844
  NPD (past)
• Andre Gualberto Sarmiento, MD

  • Internal Medicine Physician
  • Wilmington, NC
  • NPI 1194711192
  NPD (past)

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1356566400000",
    "number": "1639201056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2215 CANTERWOOD DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017301",
            "telephone_number": "910-762-4600",
            "fax_number": "910-762-9483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 CANTERWOOD DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017301",
            "telephone_number": "910-762-4600",
            "fax_number": "910-762-9483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILMINGTON INTERNAL MEDICINE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-12",
        "last_updated": "2012-12-27",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "WENDY",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "910-762-4600",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "85716",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7978365",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER #",
            "identifier": "0176C",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wilmington Health PLLC
• Wilmington Health PLLC
• Wilmington Health PLLC
• Wilmington Hearing Specialists PA
• Wilmington Home Health Care
• Wilmington Maternal-Fetal Medicine, PLLC
• Wilmington Medical Care
• Wilmington Medical Group PA
• Wilmington Medical Supply Inc
• Wilmington Mental Health, PLLC

• Internal Medicine Physician in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Internal Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.