NPIMap

Organization Active NPI

Wilmington Health PLLC

  • Family Medicine Physician
  • Jacksonville, NC
National Provider Identifier
1912210865
Registry record updated May 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
73991 Issued in NC
Legal business name
WILMINGTON HEALTH PLLC
Practice address
1000 Brabham Avenue
Jacksonville, NC 28546-5003
Phone
(910) 347-1515
Fax
(910) 347-7982
NPI assigned
Jul 21, 2010
Last updated
May 6, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2015

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

Authorized official

Name
Chasity Chace
Title
Director of Business Office
Phone
(910) 341-3384

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 73991 NC Primary

Addresses

Primary practice location

1000 Brabham Avenue
Jacksonville, NC 28546-5003

Mailing address

PO Box 600002
Raleigh, NC 27675-6002
Phone (910) 341-3300

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031208000800 NC Part B Supplier - Clinic/Group Practice 6103722509 Receives reassigned benefits from 489 practitioners
12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Jacksonville, NC; Wilmington, NC; Leland, NC; Hampstead, NC; Carolina Beach, NC

Other NPIs on the same Medicare enrollment 12

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

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
34D1048184Wilmington Health (Jacksonville)1000 Brabham Avenue, Jacksonville, NC 28546AccreditationNov 18, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1279670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430870400000",
    "number": "1912210865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 600002",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276756002",
            "telephone_number": "910-341-3300",
            "fax_number": "910-347-7982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 BRABHAM AVENUE",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285465003",
            "telephone_number": "910-347-1515",
            "fax_number": "910-347-7982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILMINGTON HEALTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-21",
        "last_updated": "2015-05-06",
        "status": "A",
        "authorized_official_last_name": "CHACE",
        "authorized_official_first_name": "CHASITY",
        "authorized_official_title_or_position": "DIRECTOR OF BUSINESS OFFICE",
        "authorized_official_telephone_number": "910-341-3384"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "73991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2015; 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.