Individual provider Active NPI

Charles T Woodham, M.D.

  • Surgery Physician
  • Raleigh, NC
National Provider Identifier
1699968933
Registry record updated Apr 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
2016-01287 Issued in NC
Practice address
3024 New Bern Ave
Raleigh, NC 27610-1247
Phone
(919) 350-7331
NPI assigned
Aug 21, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 7823 AK
Surgery Physician 208600000X 2016-01287 NC Primary

Addresses

Primary practice location

3024 New Bern Ave
Raleigh, NC 27610-1247

Mailing address

2920 Highwoods Blvd
Raleigh, NC 27604-0010
Phone (877) 498-4490

Other practice location 1

5955 Zeamer Ave
673rd MDG
Jber, AK 99506-3702
Phone (907) 580-1035

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cwoodham249898@directHISP.wakemed.org Direct

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160906001973 NC Practitioner - General Surgery 3476702697 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
St. Louis College of Physicians and Surgeons, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wakemed Specialists Group LLCGroup PAC ID 2466788377, 868 clinicians

Practice addresses (Care Compare)

3024 New Bern Ave
Raleigh, NC 27610-1247
Phone (919) 350-7856

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
7823AKMDSurgery Physician
2016-01287NCMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Moses Cone Physician Services, Inc. Surgery Current Accepting new patients
Wakemed Specialists Group, LLC Surgery Current Accepting new patients
Wakemed Specialists Group LLC Surgery CurrentSince Aug 22, 2019 Accepting new patients
Moses Cone Physician Services Inc CurrentSince Apr 1, 2019 Accepting new patients
Cornerstone Medical Center, PA Current Accepting new patients
Wakemed Specialists Group LLC CurrentSince Aug 22, 2019 Accepting new patients

Locations

1041 Kirkpatrick Rd
Ste 150
Burlington, NC 27215
Phone (336) 538-1888

1041 Kirkpatrick Rd
Ste 100
Burlington, NC 27215
Phone (336) 538-0089

1236 Huffman Mill Rd
Ste 2900
Burlington, NC 27215
Phone (336) 584-6868

1200 N Elm St
Greensboro, NC 27401
Phone (336) 574-7000

3940 Arrowhead Blvd
Ste 230
Mebane, NC 27302
Phone (336) 227-2761

3024 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-5318

10010 Falls of Neuse Rd
Raleigh, NC 27614
Phone (919) 350-1380

10000 Falls of Neuse Rd
Raleigh, NC 27614
Phone (919) 350-1300

2920 Highwoods Blvd
Raleigh, NC 27604

3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000

1030 Siena Dr
Wake Forest, NC 27587
Phone (919) 235-6511

Interoperability endpoints

  • Direct secure messaging: cwoodham249898@directhisp.wakemed.org

Organizations & group practices 6

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.

Hospital & facility affiliations 3

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": "1187654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618444800000",
    "number": "1699968933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2920 HIGHWOODS BLVD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276040010",
            "telephone_number": "877-498-4490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3024 NEW BERN AVE",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276101247",
            "telephone_number": "919-350-7331"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5955 Zeamer Ave",
            "address_2": "673rd MDG",
            "address_purpose": "LOCATION",
            "city": "JBER",
            "state": "AK",
            "postal_code": "995063702",
            "country_code": "US",
            "telephone_number": "907-580-1035",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOODHAM",
        "first_name": "CHARLES",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-21",
        "last_updated": "2021-04-15",
        "certification_date": "2021-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AK",
            "license": "7823",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "2016-01287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cwoodham249898@directHISP.wakemed.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "xml",
            "address_1": "3024 New Bern Ave",
            "city": "Raleigh",
            "state": "NC",
            "country_code": "US",
            "postal_code": "276101247",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.