Julian David Willoughby, MD

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

2017-01920 Issued in NC

Practice address

110 Lake Concord Rd NE
Concord, NC 28025-2918

Phone

(704) 792-2672

Fax

(704) 792-2674

NPI assigned

May 21, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 3

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

Specialty

Physical Medicine and Rehabilitation

Education

University of North Carolina at Chapel Hill School of Medicine, 2012

Medicare assignment

May accept Medicare assignment

Group practices

Atrium Health Neurospine Network LLCGroup PAC ID 1052800588, 121 clinicians

Carolina Neurosurgery and Spine Associates PAGroup PAC ID 7214833375, 104 clinicians

Comprehab, IncGroup PAC ID 2769653757, 376 clinicians

Oxford Physical Therapy and RehabilitationGroup PAC ID 0244232874, 432 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Carolinas Medical Center-Northeast Hospital, Concord, NC, CCN 340001
• Stanly Regional Medical Center Hospital, Albemarle, NC, CCN 340119

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mw_jwilloughby@sos1359.srs-direct.com
• Direct secure messaging: jwilloughby288049@carolinashealthcaresystem.direct-ci.com
• FHIR API: https://epicproxy.et0905.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Atrium Health Neurospine Network LLC

  • Neurological Surgery Physician
  • Charlotte, NC
  • NPI 1033007695
  Medicare reassignment Care Compare group NPD
• Carolina Neurosurgery & Spine Associates PA

  • Neurological Surgery Physician
  • Charlotte, NC
  • NPI 1154384568
  Medicare reassignment Care Compare group NPD
• Carolinas Medical Center

  • Obstetrics & Gynecology Physician
  • Charlotte, NC
  • NPI 1275774333
  Medicare reassignment NPD
• Carolinas Physicians Network Inc

  • Orthopaedic Surgery Physician
  • Charlotte, NC
  • NPI 1437607686
  Medicare reassignment NPD
• Comprehab LLC

  • Physical Therapist
  • Gastonia, NC
  • NPI 1407932775
  Care Compare group
• Oxford Physical Therapy and Rehabilitation

  • Physical Therapist
  • Mason, OH
  • NPI 1326126061
  Care Compare group
• Carolinas Medical Center

  • Surgical Critical Care Physician
  • Charlotte, NC
  • NPI 1699979732
  NPD
• Carolinas Medical Center

  • Community/Retail Pharmacy
  • Charlotte, NC
  • NPI 1982710554
  NPD
• Carolinas Pathology Group, PA

  • Specialist
  • Charlotte, NC
  • NPI 1689628158
  NPD
• Carolinas Physicians Network Inc

  • Sports Medicine (Family Medicine) Physician
  • Charlotte, NC
  • NPI 1386991297
  NPD
• Carolinas Physicians Network Inc

  • Endocrinology, Diabetes & Metabolism Physician
  • Charlotte, NC
  • NPI 1437038544
  NPD
• Atrium Health Neurospine Network LLC

  • Neurological Surgery Physician
  • Rock Hill, SC
  • NPI 1831081454
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Atrium Health Hospitals Inc

  • General Acute Care Hospital
  • Albemarle, NC
  • NPI 1104627926
  Care Compare affiliation
• Atrium Health Hospitals Inc

  • Psychiatric Hospital Unit
  • Albemarle, NC
  • NPI 1740081553
  Care Compare affiliation
• The Charlotte-Mecklenburg Hospital Authority

  • General Acute Care Hospital
  • Concord, NC
  • NPI 1487866315
  Care Compare affiliation
• The Charlotte-Mecklenburg Hospital Authority

  • Psychiatric Hospital Unit
  • Concord, NC
  • NPI 1629283866
  Care Compare affiliation

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

{
    "created_epoch": "1337558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710892800000",
    "number": "1659631984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 BALDWIN AVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043109",
            "telephone_number": "704-376-1605",
            "fax_number": "704-335-8448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 LAKE CONCORD RD NE",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252918",
            "telephone_number": "704-792-2672",
            "fax_number": "704-792-2674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLOUGHBY",
        "first_name": "JULIAN",
        "middle_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-21",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NC",
            "license": "2017-01920",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1659631984",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jwilloughby288049@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "1100 Blythe Blvd",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282035814",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "julian.willoughby.p1@direct.cnsa.nextgenshare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "225 Baldwin Ave",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282043109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Meikayla Zhane Williams
• Ondrea Williams, LPN
• Peter Williams, MS, LPCA
• Richard Franklin Williams, MD
• Kimberly Williamson
• Willow Speech Therapy
• Adrianna Celeste Wilson, LCAS
• Alexis Wilson
• Amanda Shew Wilson, RN
• Angela Cole Wilson, ANP-BC, PMHNP-BC

• Physical Medicine & Rehabilitation Physician in Concord, NC
• Providers in Concord, NC by specialty
• Physical Medicine & Rehabilitation Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.