Individual provider Active NPI

Karen Mary Wahle

  • Nurse Practitioner
  • Durham, NC
National Provider Identifier
1669859146
Registry record updated May 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5007617 Issued in NC
Practice address
2511 Old Cornwallis Road
Suite #200
Durham, NC 27713
Phone
(919) 932-5700
Fax
(919) 933-6881
NPI assigned
May 4, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 0024172406 VA
Nurse Practitioner 363L00000X 5007617 NC Primary

Addresses

Primary practice location

2511 Old Cornwallis Road
Suite #200
Durham, NC 27713

Mailing address

2511 Old Cornwallis Road
Suite #200
Durham, NC 27713
Phone (919) 932-5700

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0024172406VAMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1430697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430697600000",
    "number": "1669859146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2511 OLD CORNWALLIS ROAD",
            "address_2": "SUITE #200",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "27713",
            "telephone_number": "919-932-5700",
            "fax_number": "919-933-6881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2511 OLD CORNWALLIS ROAD",
            "address_2": "SUITE #200",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "27713",
            "telephone_number": "919-932-5700",
            "fax_number": "919-933-6881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAHLE",
        "first_name": "KAREN",
        "middle_name": "MARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-04",
        "last_updated": "2015-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024172406",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5007617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2015; 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.