Active NPI
Hadley Huske Wilson
- Surgery Physician
- Charlotte, NC
National Provider Identifier
1760019996
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 260928
- Practice address
- 1000 Blythe Blvd Ste 601
Charlotte, NC 28203-5871 - Phone
- (704) 355-7874
- Fax
- (704) 355-5619
- NPI assigned
- Mar 26, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 260928 | NC | Primary |
Addresses
Primary practice location
1000 Blythe Blvd Ste 601
Charlotte, NC 28203-5871
Mailing address
1000 Blythe Blvd Ste 601
Charlotte, NC 28203-5871
Phone (704) 355-7874
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200701000060 | NC | Order and Referring Only - General Surgery | 4587087028 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 260928 | NC | MD | Surgery Physician |
Interoperability endpoints
- hwilson631509@carolinashealthcaresystem.direct-ci.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1586217600000",
"number": "1760019996",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 BLYTHE BLVD STE 601",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282035871",
"telephone_number": "704-355-7874",
"fax_number": "704-355-5619"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 BLYTHE BLVD STE 601",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282035871",
"telephone_number": "704-355-7874",
"fax_number": "704-355-5619"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "HADLEY",
"middle_name": "HUSKE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-03-26",
"last_updated": "2020-04-07",
"certification_date": "2020-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "NC",
"license": "260928",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2020; 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.