Kendall Whitfield Wannamaker Jr., M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

2021-01183 Issued in NC

Practice address

2170 Midland Rd
Southern Pines, NC 28387-2927

Phone

(910) 295-2100

Fax

(910) 295-3625

NPI assigned

Jun 5, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other names 1

• Dr. Kendall W Wannamaker Jr. Other name

Electronic endpoints 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Ophthalmology

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carolina Eye Associates IncGroup PAC ID 0446245864, 39 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

86.76 of 100Reported as group

Quality

87.45

Promoting interoperability

97

Improvement activities

40

Cost

70.93

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Carolina Eye Associates Inc

  • Ophthalmology Physician
  • Dunn, NC
  • NPI 1861655714
  Medicare reassignment Care Compare group
• Carolina Eye Associates Inc

  • Optometrist
  • Raeford, NC
  • NPI 1093305732
  NPD
• Carolina Eye Associates Inc

  • Ophthalmology Physician
  • Southern Pines, NC
  • NPI 1245211333
  NPD
• Carolina Eye Associates Inc

  • Ophthalmology Physician
  • Fayetteville, NC
  • NPI 1265587828
  NPD
• Carolina Eye Associates Inc

  • Ophthalmology Physician
  • Albemarle, NC
  • NPI 1649349291
  NPD

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

{
    "created_epoch": "1433462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703030400000",
    "number": "1962882886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2170 MIDLAND RD",
            "city": "SOUTHERN PINES",
            "state": "NC",
            "postal_code": "283872927",
            "telephone_number": "910-295-2100",
            "fax_number": "910-295-3625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2170 MIDLAND RD",
            "city": "SOUTHERN PINES",
            "state": "NC",
            "postal_code": "283872927",
            "telephone_number": "910-295-2100",
            "fax_number": "910-295-3625"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2905 N Elm St",
            "address_purpose": "LOCATION",
            "city": "Lumberton",
            "state": "NC",
            "postal_code": "283582982",
            "country_code": "US",
            "telephone_number": "310-370-0100",
            "fax_number": "910-370-0161",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1991 Fordham Dr Ste 301",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283043774",
            "country_code": "US",
            "telephone_number": "910-485-2020",
            "fax_number": "910-485-7571",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WANNAMAKER",
        "first_name": "KENDALL",
        "middle_name": "WHITFIELD",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-05",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "KY",
            "license": "TP302",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "LL38304",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "OH",
            "license": "35136292",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NC",
            "license": "2021-01183",
            "primary": true
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "NC",
            "license": "2021-01183",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Kendall.Wannamaker@direct.carolinaeye.nextgenshare.com",
            "affiliation": "N",
            "address_1": "2170 Midland Rd",
            "city": "Southern Pines",
            "state": "NC",
            "country_code": "US",
            "postal_code": "283872999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KENDALL",
            "last_name": "WANNAMAKER",
            "middle_name": "W",
            "prefix": "DR.",
            "suffix": "JR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Walgreen Co
• Susan Cook Walker, PTA
• Kathleen Michelle Wallace
• Molly McCarthy Walsh, M.D.
• Walter S Morris III MD PLLC
• Terry Theo Warner, M.S.
• Grace Warren
• Helga Wartena
• Elizabeth M Watson, PMH-NP
• Russell Martin Weaver, DDS

• Ophthalmology Physician in Southern Pines, NC
• Providers in Southern Pines, NC by specialty
• Ophthalmology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.