Organization Active NPI

S. Terry Withers, Jr., M.D.

  • Family Medicine Physician
  • Wilmington, NC
National Provider Identifier
1831363688
Registry record updated Nov 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
S. TERRY WITHERS, JR., M.D.
Practice address
5058 Wrightsville Ave
Wilmington, NC 28403-7048
Phone
(910) 791-5426
Fax
(910) 799-2433
NPI assigned
Apr 14, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2010

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

Authorized official

Name
Dr. S. Terry Withers Jr., M.D.
Title
Owner
Phone
(910) 791-5426

Specialties & licenses 1

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

Addresses

Primary practice location

5058 Wrightsville Ave
Wilmington, NC 28403-7048

Mailing address

PO Box 598
Wrightsville Beach, NC 28480-0598
Phone (910) 791-5426

Other identifiers 3

IdentifierTypeStateIssuer
5902268MedicaidNC
1356532659OtherNPI
1639240617OtherNPI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1208131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289779200000",
    "number": "1831363688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 598",
            "city": "WRIGHTSVILLE BEACH",
            "state": "NC",
            "postal_code": "284800598",
            "telephone_number": "910-791-5426",
            "fax_number": "910-799-2433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5058 WRIGHTSVILLE AVE",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284037048",
            "telephone_number": "910-791-5426",
            "fax_number": "910-799-2433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S. TERRY WITHERS, JR., M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-14",
        "last_updated": "2010-11-15",
        "status": "A",
        "authorized_official_last_name": "WITHERS",
        "authorized_official_first_name": "S.",
        "authorized_official_middle_name": "TERRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "910-791-5426",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5902268",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1356532659",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1639240617",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.