Nicole Sharon Wellbaum, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

2016-00705 Issued in NC

Practice address

131 Medical Park Rd Ste 102
Mooresville, NC 28117-8523

Phone

(704) 663-1282

Fax

(704) 663-1413

NPI assigned

Jun 26, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Obstetrics/Gynecology

Education

University of South Carolina School of Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Piedmont Healthcare PAGroup PAC ID 9638070683, 226 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Duke Health Lake Norman Hospital Hospital, Mooresville, NC, CCN 340129

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nicolewellbaum@phc.allscriptsdirect.net

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.

• Piedmont Healthcare, P.a.

  • Internal Medicine Physician
  • Statesville, NC
  • NPI 1912999897

  Obstetrics & Gynecology

  Medicare reassignment Care Compare group NPD
• Piedmont Healthcare, PA

  • Durable Medical Equipment & Medical Supplies
  • Statesville, NC
  • NPI 1639041320
  NPD

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

• Duke Health Lake Norman Regional Medical Center, Inc.

  • General Acute Care Hospital
  • Mooresville, NC
  • NPI 1114731064
  Care Compare affiliation

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

{
    "created_epoch": "1340668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505865600000",
    "number": "1740544600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1845",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286871845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 MEDICAL PARK RD STE 102",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281178523",
            "telephone_number": "704-663-1282",
            "fax_number": "704-663-1413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLBAUM",
        "first_name": "NICOLE",
        "middle_name": "SHARON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-26",
        "last_updated": "2017-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NC",
            "license": "2016-00705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katie Holcomb Weeks
• Raphael D. Weeks, O.D.
• Caryn E Weferling, OTR/L
• Aliana Welfare
• Kevin David Wellbaum, M.D.
• Wellcomemd NC Clinic PLLC
• Wellness Psychiatry Group, P.C.
• Wellness Source, Inc.
• James D Wells Jr., LCMHC
• Douglas Lee Welsh

• Obstetrics & Gynecology Physician in Mooresville, NC
• Providers in Mooresville, NC by specialty
• Obstetrics & Gynecology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2017; 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.