Individual provider Active NPI

Winfry Evans Whicker, M.D.

  • Primary Care Clinic/Center
  • Concord, NC
National Provider Identifier
1649586330
Registry record updated Aug 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
13948 Issued in NC
Practice address
3700 Taylor Glen LN NW
#355
Concord, NC 28027-3400
Phone
(704) 652-7464
NPI assigned
Aug 19, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 13948 NC Primary

Addresses

Primary practice location

3700 Taylor Glen LN NW
#355
Concord, NC 28027-3400

Mailing address

3700 Taylor Glen LN NW
#355
Concord, NC 28027-3400
Phone (704) 652-7464

Other identifiers 1

IdentifierTypeStateIssuer
2939OtherNCGENERAL MEDICAL

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
13948NCMDPrimary Care Clinic/Center
20273SCMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1282176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282176000000",
    "number": "1649586330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 TAYLOR GLEN LN NW",
            "address_2": "#355",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280273400",
            "telephone_number": "704-652-7464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 TAYLOR GLEN LN NW",
            "address_2": "#355",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280273400",
            "telephone_number": "704-652-7464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHICKER",
        "first_name": "WINFRY",
        "middle_name": "EVANS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-08-19",
        "last_updated": "2010-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NC",
            "license": "13948",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GENERAL MEDICAL",
            "identifier": "2939",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2010; 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.