Randall Norman Willard, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

200400437 Issued in NC

Practice address

4402 Shipyard Blvd
Wilmington, NC 28403-6161

Phone

(910) 452-1400

Fax

(910) 332-1072

NPI assigned

Jun 13, 2005

Last updated

Nov 24, 2009By the provider in NPPES

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 5

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rwillard1253233@direct.novanthealth.org

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.

• Ecep II PA

  • Emergency Medicine Physician
  • Burgaw, NC
  • NPI 1255407680
  Medicare reassignment NPD
• Novant Health Medical Group Coastal Region, LLC

  dba NHMGCR Cape Fear Heart

  • Cardiovascular Disease Physician
  • Wilmington, NC
  • NPI 1649865791
  Medicare reassignment NPD
• Novant Health New Hanover Regional Medical Center LLC

  • Certified Registered Nurse Anesthetist
  • Wilmington, NC
  • NPI 1750978839
  Medicare reassignment NPD
• Ecep II PA

  • Emergency Medicine Physician
  • Wilmington, NC
  • NPI 1558755165
  NPD
• Ecep II PA

  • Emergency Medicine Physician
  • Wilmington, NC
  • NPI 1831265263
  NPD
• NMG Health Services LLC

  • Maternal & Fetal Medicine Physician
  • Bolivia, NC
  • NPI 1558242495
  NPD
• Novant Health Medical Group Coastal Region, LLC

  dba NHRMC Physician Specialists - Internal Medicine Specialists

  • Internal Medicine Physician
  • Wilmington, NC
  • NPI 1912587528
  NPD
• Novant Health New Hanover Regional Medical Center LLC

  dba Novant Health New Hanover Wound Care and Hyperbaric Medicine Profee

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Wilmington, NC
  • NPI 1932958584
  NPD
• Emergency Medicine Physicians of Craven County, PLLC

  • Emergency Medicine Physician
  • New Bern, NC
  • NPI 1164462586
  NPD (past)
• Ochsner Eye, PA

  • Ophthalmology Physician
  • Wilmington, NC
  • NPI 1205249539
  NPD (past)
• Pender Memorial Hospital, Incorporated

  dba Novant Health Pender Medical Center

  • Critical Access Hospital
  • Burgaw, NC
  • NPI 1295703130
  NPD (past)

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259020800000",
    "number": "1700880101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4402 SHIPYARD BLVD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284036161",
            "telephone_number": "910-452-1400",
            "fax_number": "910-332-1072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4402 SHIPYARD BLVD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284036161",
            "telephone_number": "910-452-1400",
            "fax_number": "910-332-1072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLARD",
        "first_name": "RANDALL",
        "middle_name": "NORMAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2009-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "200400437",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00311531",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q0043G",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "D7960",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1368Y",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891368Y",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wilhelm and Parkhurst, DDS,PA
• Jack Lee Wilhelm, DDS
• Robert Alexander Wilkerson
• Nakia Marie Wilkes, ICADC, CADC
• Jennifer Stephenson Wilkins, PT, DPT
• William D Kassens, Jr MD PA
• William H. Cooper, IV, MD, PA
• William S Bennett PHD PC
• Kristin Janelle Williams Brown, MD
• Amy Williams, MA

• Emergency Medicine Physician in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Emergency Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.