Individual provider Active NPI

Maria Graziella Dichoso-Wood, MD

  • Family Medicine Physician
  • Charlotte, NC
National Provider Identifier
1932163227
Registry record updated Dec 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
9600312 Issued in NC
Practice address
1901 Randolph Rd
Charlotte, NC 28207-1101
Phone
(704) 384-5420
NPI assigned
Apr 13, 2006
Last updated
Dec 14, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35-084496 OH
Family Medicine Physician 207Q00000X 9600312 NC Primary

Addresses

Primary practice location

1901 Randolph Rd
Charlotte, NC 28207-1101

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other practice location 1

4503 Old Monroe Rd
Indian Trail, NC 28079-5309
Phone (704) 821-6900

Other identifiers 3

IdentifierTypeStateIssuer
8928493MedicaidNC
N0031CMedicaidSC
2594214MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040503001340 NC Practitioner - Family PracticePractitioner - Hospitalist 8527056100 Reassigns benefits to 1 organization
I20220210000639 SC Practitioner - Family Practice 8527056100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35-084496OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Union CurrentSince Jul 6, 2020 Accepting new patients
Internal Medicine Specialists, Inc Past Accepting new patients
Union County Public Schools PastSince Jul 6, 2020 Accepting new patients

Locations

2330 Concord Ave
Monroe, NC 28110
Phone (704) 296-4300

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16545/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544745600000",
    "number": "1932163227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 RANDOLPH RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071101",
            "telephone_number": "704-384-5420"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4503 Old Monroe Rd",
            "address_purpose": "LOCATION",
            "city": "Indian Trail",
            "state": "NC",
            "postal_code": "280795309",
            "country_code": "US",
            "telephone_number": "704-821-6900",
            "fax_number": "704-821-6911",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DICHOSO-WOOD",
        "first_name": "MARIA",
        "middle_name": "GRAZIELLA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-13",
        "last_updated": "2018-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35-084496",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "9600312",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8928493",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N0031C",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2594214",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.