Individual provider Active NPI

Emily Ann Wheeler, PA-C

  • Physician Assistant
  • Matthews, NC
National Provider Identifier
1962684266
Registry record updated Nov 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-01261 Issued in NC
Practice address
9600 E Independence Blvd Ste B
Matthews, NC 28105-4628
Phone
(704) 815-5624
Fax
(704) 815-5621
NPI assigned
Nov 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 0010-01261 NC
Physician Assistant 363A00000X 0010-01261 NC Primary

Addresses

Primary practice location

9600 E Independence Blvd Ste B
Matthews, NC 28105-4628

Mailing address

PO Box 601843
Charlotte, NC 28260-1843

Other practice location 1

404 S Sutherland Ave
Monroe, NC 28112-5060
Phone (704) 291-9267

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090330000723 NC Practitioner - Physician Assistant 4688731078 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Medical University of South Carolina College of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolina Medicorp Enterprises LLCGroup PAC ID 0648174904, 184 clinicians

Practice addresses (Care Compare)

1302 Wesley Chapel Rd
Suite a
Indian Trail, NC 28079-5243
Phone (704) 635-6411

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-01261NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Medicorp Enterprises, LLC CurrentSince Nov 2, 2024 Accepting new patients
Carolina Medicorp Enterprises, LLC CurrentSince Nov 2, 2024 Accepting new patients
Ballantyne Emergency Physicians PLLC CurrentSince May 1, 2020 Accepting new patients
Carolina Medicorp Enterprises Inc Past Accepting new patients

Locations

11516 Providence Rd
Charlotte, NC 28277
Phone (704) 667-0370

9550 Rocky River Rd
Ste 150
Charlotte, NC 28215
Phone (704) 457-1510

9600 E Independence Blvd
#B
Matthews, NC 28105
Phone (704) 815-5624

600 Highland Oaks Dr
Winston Salem, NC 27103
Phone (366) 774-0040

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
  • Direct secure messaging: ewheeler1615331@direct.novanthealth.org

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1196294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732579200000",
    "number": "1962684266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 601843",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282601843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9600 E INDEPENDENCE BLVD STE B",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281054628",
            "telephone_number": "704-815-5624",
            "fax_number": "704-815-5621"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "404 S Sutherland Ave",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "NC",
            "postal_code": "281125060",
            "country_code": "US",
            "telephone_number": "704-291-9267",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHEELER",
        "first_name": "EMILY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-29",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-01261",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-01261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Matthews, NC

Sources for this page

Verify at the official NPI Registry.