Organization Active NPI

Wendover Primary Care Clinic, PLLC

  • Family Medicine Physician
  • Charlotte, NC
National Provider Identifier
1780053082
Registry record updated Dec 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
WENDOVER PRIMARY CARE CLINIC, PLLC
Practice address
5109 Monroe Rd Ste E
Charlotte, NC 28205-7878
Phone
(704) 364-4216
Fax
(704) 366-6391
NPI assigned
Sep 17, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2025

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

Authorized official

Name
Dr. Rene Chike Anikwue, MDNPI 1811296494
Title
President
Phone
(704) 900-5194

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

5109 Monroe Rd Ste E
Charlotte, NC 28205-7878

Mailing address

5109 Monroe Rd Ste E
Charlotte, NC 28205-7879
Phone (704) 900-5194

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201228001769 NC Part B Supplier - Clinic/Group Practice 1759665722 Receives reassigned benefits from 1 practitioner
Practice locations: Charlotte, NC

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D2152957Wendover Primary Care Clinic, PLLC5109 Monroe Rd, Ste E, Charlotte, NC 28205Certificate of waiverAug 20, 2026

National Provider Directory

National Provider Directory

Locations

485 N Wendover Rd
Charlotte, NC 28211
Phone (704) 364-4216

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22236/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1442448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765324800000",
    "number": "1780053082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5109 MONROE RD STE E",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282057879",
            "telephone_number": "704-900-5194",
            "fax_number": "833-974-2188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5109 MONROE RD STE E",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282057878",
            "telephone_number": "704-364-4216",
            "fax_number": "704-366-6391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WENDOVER PRIMARY CARE CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-17",
        "last_updated": "2025-12-10",
        "certification_date": "2025-12-10",
        "status": "A",
        "authorized_official_last_name": "ANIKWUE",
        "authorized_official_first_name": "RENE",
        "authorized_official_middle_name": "CHIKE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-900-5194",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "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 Dec 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.