James M. Mertesdorf, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

27826 Issued in NC

Practice address

1515 Doctors Cir
Hanover Medical Specialists
Wilmington, NC 28401-7403

Phone

(910) 763-1219

Fax

(910) 763-0291

NPI assigned

Sep 7, 2005

Last updated

Nov 29, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Health Sciences Foundation Inc.

  dba DBA University Professional Services

  • Internal Medicine Physician
  • Wilmington, NC
  • NPI 1942288600
  NPD (past)

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

{
    "created_epoch": "1126051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196294400000",
    "number": "1891789756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 DOCTORS CIR",
            "address_2": "HANOVER MEDICAL SPECIALISTS",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017403",
            "telephone_number": "910-763-1219",
            "fax_number": "910-763-0291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 DOCTORS CIR",
            "address_2": "HANOVER MEDICAL SPECIALISTS",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017403",
            "telephone_number": "910-763-1219",
            "fax_number": "910-763-0291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERTESDORF",
        "first_name": "JAMES",
        "middle_name": "M.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-07",
        "last_updated": "2007-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NC",
            "license": "27826",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8958702",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicole Reya Merrigan, MA, LPA
• Matthew R Merrill, FNP
• Melissa Merritt, OTR
• Stacie Ann Merritt, PT
• Brittany Nicole Merryman, LCSWA
• Patrick Robert Merwin, COTA/L
• Srinivas Rao Mesineni
• Sarah Accattato Messick
• Amy Eileen Messier, MD
• Matthew Roland Messier, MD

• Gastroenterology Physician in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Gastroenterology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2007; 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.