Individual provider Active NPI

Donette Weltansieht Vicente, M.D.

  • Hematology & Oncology Physician
  • Raleigh, NC
National Provider Identifier
1700063062
Registry record updated Aug 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
2016-00099 Issued in NC
Practice address
2901 Blue Ridge Rd Ste 203
Raleigh, NC 27607-6423
Phone
(919) 784-6818
NPI assigned
Jan 29, 2008
Last updated
Aug 18, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 234963 MA
Hematology & Oncology Physician 207RH0003X 49486 TN
Hematology & Oncology Physician 207RH0003X 2016-00099 NC Primary
Medical Oncology Physician 207RX0202X 2016-00099 NC

Addresses

Primary practice location

2901 Blue Ridge Rd Ste 203
Raleigh, NC 27607-6423

Mailing address

2901 Blue Ridge Rd Ste 203
Raleigh, NC 27607-6423
Phone (919) 784-6818

Other identifiers 1

IdentifierTypeStateIssuer
103I839379OtherTNMEDICARE PTAN

Other names 1

  • Donette Weltansieht Campbell Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dvicente172427@direct.UNC.nchie.net 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
I20160404001397 NC Practitioner - Medical OncologyPractitioner - Hematology/Oncology 9436214491 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Medical OncologyAlso: Hematology/Oncology
Education
State University of New York at Stony Brook, School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Carolina MG LLCGroup PAC ID 1951828847, 723 clinicians

Practice addresses (Care Compare)

2901 Blue Ridge Rd
Raleigh, NC 27607-6423
Phone (919) 784-3105

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
234963MAMDInternal Medicine Physician
2016-00099NCMDMedical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rex Hospital Inc Internal Medicine Current Accepting new patients
Rex Hospital, Inc CurrentSince Oct 1, 2019 Accepting new patients
DLP Maria Parham Physician Practices, LLC Current Accepting new patients
North Carolina MG, LLC Hematology & Oncology CurrentSince Nov 1, 2025 Accepting new patients
DLP Maria Parham Physician Practices, LLC Hematology & Oncology CurrentSince Apr 1, 2016 Accepting new patients
DLP Maria Parham Physician Practices LLC CurrentSince Apr 1, 2016 Accepting new patients
Johnston Specialty Physician Services,Inc Hematology & Oncology CurrentSince Mar 1, 2018 Accepting new patients
Johnston Specialty Physician Services,Inc Internal Medicine Current Accepting new patients
Rex Hospital Inc Hematology & Oncology CurrentSince Oct 1, 2019 Accepting new patients
Rex Hospital Inc Past Accepting new patients

Locations

120 Charles Rollins Rd
Ste 105
Henderson, NC 27536
Phone (252) 438-2773

566 Ruin Creek Rd
Henderson, NC 27536
Phone (252) 436-1148

1200 Pine Run Dr
Lumberton, NC 28358
Phone (910) 671-5048

5221 Paramount Pkwy
Ste 420
Morrisville, NC 27560
Phone (984) 215-6533

117 Sunnybrook Rd
Raleigh, NC 27610
Phone (919) 334-3900

2901 Blue Ridge Rd
Raleigh, NC 27607
Phone (919) 784-3105

2901 Blue Ridge Rd
Ste 203
Raleigh, NC 27607
Phone (919) 784-6060

4420 Lake Boone Trl
Raleigh, NC 27607
Phone (919) 784-3034

509 N Brightleaf Blvd
Smithfield, NC 27577
Phone (919) 934-8171

514 N Brightleaf Blvd
Ste 1100
Smithfield, NC 27577
Phone (919) 939-2192

Interoperability endpoints

  • Direct secure messaging: dvicente172427@direct.unc.nchie.net

Organizations & group practices 10

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 2

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": "1201564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660780800000",
    "number": "1700063062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 BLUE RIDGE RD STE 203",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276076423",
            "telephone_number": "919-784-6818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 BLUE RIDGE RD STE 203",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276076423",
            "telephone_number": "919-784-6818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICENTE",
        "first_name": "DONETTE",
        "middle_name": "WELTANSIEHT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-29",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "234963",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "TN",
            "license": "49486",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NC",
            "license": "2016-00099",
            "primary": true
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "NC",
            "license": "2016-00099",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "103I839379",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dvicente172427@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "2901 Blue Ridge Rd Ste 203",
            "city": "Raleigh",
            "state": "NC",
            "country_code": "US",
            "postal_code": "276076423",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "DONETTE",
            "last_name": "CAMPBELL",
            "middle_name": "WELTANSIEHT",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.