Individual provider Active NPI

Heather Dawn Pacholke, M.D.

  • Radiation Oncology Physician
  • Albemarle, NC
National Provider Identifier
1790744712
Registry record updated Dec 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
200500230 Issued in NC
Practice address
301 Yadkin St
Albemarle, NC 28001-3441
Phone
(704) 984-4000
Fax
(704) 983-8250
NPI assigned
Mar 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 200500230 NC Primary

Addresses

Primary practice location

301 Yadkin St
Albemarle, NC 28001-3441

Mailing address

200 Queens Rd
Suite 400
Charlotte, NC 28204-3253
Phone (704) 333-7376

Other identifiers 11

IdentifierTypeStateIssuer
2040419BOtherNCMEDICARE PTAN
6365761OtherCIGNA
2040419COtherNCMEDICARE PTAN
5901549MedicaidNC
806973OtherPARTNERS
P00712368OtherNCMEDICARE - RAILROAD
2544164OtherUNITED HEALTHCARE
E3975OtherMEDCOST
13933OtherNCBLUE CROSS
2040419AOtherNCMEDICARE PTAN
2040419DOtherNCMEDICARE PTAN

Other names 1

  • Heather Dawn Weeks Former name

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050620000854 NC Practitioner - Radiation Oncology 0244275345 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Indiana University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wake Forest University Health SciencesGroup PAC ID 4486564952, 2,633 clinicians

Practice addresses (Care Compare)

601 N Elm St
High Point, NC 27262-4331
Phone (336) 716-2734

Hospital & facility affiliations

  • High Point Regional Health System Hospital, High Point, NC, CCN 340004

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200500230NCMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest University Health Sciences CurrentSince Sep 2, 2018 Accepting new patients
Longmont United Hospital Past Accepting new patients
Piedmont Carolinas Radiation Therapy LLC Past Accepting new patients
Piedmont Carolinas Radiation Therapy LLC Past Accepting new patients

Locations

601 N Elm St
High Point, NC 27262
Phone (336) 878-6419

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

Interoperability endpoints

  • Direct secure messaging: hpacholke108649@direct.unc.nchie.net
  • Direct secure messaging: hpacholke2754764@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1142812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355875200000",
    "number": "1790744712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 QUEENS RD",
            "address_2": "SUITE 400",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043253",
            "telephone_number": "704-333-7376",
            "fax_number": "704-333-3397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 YADKIN ST",
            "city": "ALBEMARLE",
            "state": "NC",
            "postal_code": "280013441",
            "telephone_number": "704-984-4000",
            "fax_number": "704-983-8250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACHOLKE",
        "first_name": "HEATHER",
        "middle_name": "DAWN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-20",
        "last_updated": "2012-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "NC",
            "license": "200500230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "2040419B",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "6365761",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "2040419C",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5901549",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARTNERS",
            "identifier": "806973",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE - RAILROAD",
            "identifier": "P00712368",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "2544164",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "E3975",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "13933",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "2040419A",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "2040419D",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "WEEKS",
            "middle_name": "DAWN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Albemarle, NC

Sources for this page

Verify at the official NPI Registry.