Individual provider Active NPI

David Donald Wangerin Lile, PA-C

  • Physician Assistant
  • Waynesville, NC
National Provider Identifier
1639263775
Registry record updated Nov 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
102410 Issued in NC
Practice address
1272 East Street
Waynesville, NC 28786
Phone
(828) 456-3511
Fax
(828) 456-3583
NPI assigned
Oct 3, 2006
Last updated
Nov 26, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 102410 NC
Physician Assistant 363A00000X 102410 NC Primary

Addresses

Primary practice location

1272 East Street
Waynesville, NC 28786

Mailing address

1272 East Street
Waynesville, NC 28786-3437
Phone (828) 456-3511

Other practice location 1

131 Walnut St
Waynesville, NC 28786-3250
Phone (828) 631-3973

Other practice location 2

1207 East St
Waynesville, NC 28786-3438
Phone (828) 631-3973

Other identifiers 1

IdentifierTypeStateIssuer
10276OtherNCBCBS

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081106000388 NC Practitioner - Physician Assistant 9931268885 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1272 E St
Waynesville, NC 28786-3437
Phone (828) 456-3511

98 Doctors Dr
Sylva, NC 28779-4502

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
102410NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Waynesville Family Practice Center PA Family Medicine Current Accepting new patients
DLP Haywood Regional Medical Center LLC CurrentSince Aug 1, 2014 Accepting new patients
DLP Western Carolina Physician Practices LLC CurrentSince Aug 1, 2014 Accepting new patients
Clyde Emergency Solutions LLC Past Accepting new patients
Haywood Women's Medical Center, PA Past Accepting new patients

Locations

262 Leroy George Dr
Clyde, NC 28721
Phone (828) 452-8210

98 Doctors Dr
Ste 200
Sylva, NC 28779
Phone (828) 586-8971

1272 East St
Waynesville, NC 28786
Phone (828) 456-3511

556 Hazelwood Ave
Waynesville, NC 28786
Phone (828) 452-8890

Interoperability endpoints

  • Direct secure messaging: david.wangerin-lile.1@9865.direct.athenahealth.com

Organizations & group practices 7

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574726400000",
    "number": "1639263775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1272 EAST STREET",
            "city": "WAYNESVILLE",
            "state": "NC",
            "postal_code": "287863437",
            "telephone_number": "828-456-3511",
            "fax_number": "828-456-3583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1272 EAST STREET",
            "city": "WAYNESVILLE",
            "state": "NC",
            "postal_code": "28786",
            "telephone_number": "828-456-3511",
            "fax_number": "828-456-3583"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "131 Walnut St",
            "address_purpose": "LOCATION",
            "city": "Waynesville",
            "state": "NC",
            "postal_code": "287863250",
            "country_code": "US",
            "telephone_number": "828-631-3973",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1207 East St",
            "address_purpose": "LOCATION",
            "city": "Waynesville",
            "state": "NC",
            "postal_code": "287863438",
            "country_code": "US",
            "telephone_number": "828-631-3973",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WANGERIN LILE",
        "first_name": "DAVID",
        "middle_name": "DONALD",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2019-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "102410",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "102410",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "10276",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waynesville, NC

Sources for this page

Verify at the official NPI Registry.