NPIMap

Individual provider Active NPI

Maxwell Johannes Diddams, MD

  • Pulmonary Disease Physician
  • Concord, NC
National Provider Identifier
1740716000
Registry record updated Jul 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
2021-00610 Issued in NC
Practice address
1090 NE Gateway CT NE Ste 201
Concord, NC 28025-2423
Phone
(704) 403-7770
Fax
(704) 403-7779
NPI assigned
May 5, 2017
Last updated
Jul 4, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 4, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 227243 NC
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 2021-00610 NC
Pulmonary Disease Physician 207RP1001X 2021-00610 NC Primary

Addresses

Primary practice location

1090 NE Gateway CT NE Ste 201
Concord, NC 28025-2423

Mailing address

1090 NE Gateway CT NE Ste 201
Concord, NC 28025-2423
Phone (704) 403-7770

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mdiddams306998@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
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211111001949 NC Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists)Practitioner - Hospitalist 2961770631 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

920 Church St N
Concord, NC 28025-2927
Phone (704) 403-1632

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2021-00610NCMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Sep 3, 2024 Accepting new patients
Carolinas Medical Center Current Accepting new patients
Carolinas Physicians Network Inc CurrentSince Oct 17, 2025 Accepting new patients
Carolinas Physicians Network Inc Internal Medicine CurrentSince Oct 17, 2025 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Internal Medicine Current Accepting new patients
University of North Carolina at Chapel Hill Internal Medicine CurrentSince Oct 20, 2021 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Sep 3, 2024 Accepting new patients
Carolinas Medical Center CurrentSince Sep 3, 2024 Accepting new patients
Carolinas Medical Center CurrentSince Sep 3, 2024 Accepting new patients
Carolinas Medical Center-Northeast Past Accepting new patients

Locations

101 Manning Dr
Chapel Hill, NC 27514
Phone (984) 974-1485

101 Manning Dr
#125
Chapel Hill, NC 27514

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

1350 S Kings Dr
Charlotte, NC 28207
Phone (704) 446-1255

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

1085 NE Gateway Ct NE
#200A
Concord, NC 28025
Phone (704) 403-8650

1090 NE Gateway Ct NE
Ste 201
Concord, NC 28025
Phone (704) 403-7770

200 Medical Park Dr
Ste 250
Concord, NC 28025
Phone (704) 403-2740

920 Church St N
Concord, NC 28025
Phone (704) 403-3000

1020 Tree of Life Ln
Cornelius, NC 28031
Phone (704) 801-7330

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

Interoperability endpoints

  • Direct secure messaging: mdiddams138466@directhisp.wakemed.org
  • Direct secure messaging: mdiddams2939738@carolinashealthcaresystem.direct-ci.com
  • Direct secure messaging: mdiddams306998@direct.unc.nchie.net

Organizations & group practices 11

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 10

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": "1493942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720051200000",
    "number": "1740716000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1090 NE GATEWAY CT NE STE 201",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252423",
            "telephone_number": "704-403-7770",
            "fax_number": "704-403-7779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 NE GATEWAY CT NE STE 201",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252423",
            "telephone_number": "704-403-7770",
            "fax_number": "704-403-7779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIDDAMS",
        "first_name": "MAXWELL",
        "middle_name": "JOHANNES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-05",
        "last_updated": "2024-07-04",
        "certification_date": "2024-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "227243",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NC",
            "license": "2021-00610",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NC",
            "license": "2021-00610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mdiddams306998@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "101 Manning Dr",
            "address_2": "125 MacNider Hall",
            "city": "Chapel Hill",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275997005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

Verify at the official NPI Registry.