Individual provider Active NPI

India Blaire Hanvey, M.D.

  • Pediatrics Physician
  • Greensboro, NC
National Provider Identifier
1083140735
Registry record updated Jun 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2020-00637 Issued in NC
Practice address
301 E Wendover Ave Ste 400
Greensboro, NC 27401-1207
Phone
(336) 832-3150
Fax
(919) 966-8419
NPI assigned
May 2, 2017
Last updated
Jun 15, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 227073 NC
Pediatrics Physician 208000000X 2020-00637 NC Primary

Addresses

Primary practice location

301 E Wendover Ave Ste 400
Greensboro, NC 27401-1207

Mailing address

301 E Wendover Ave Ste 400
Greensboro, NC 27401-1207
Phone (336) 832-3150

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200919000000 NC Practitioner - Pediatric Medicine 2062781172 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2020-00637NCMDPediatrics Physician
227073NCMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
The Moses H Cone Memorial Hospital Operating Corporation Pediatrics CurrentSince Sep 13, 2020 Accepting new patients
The Moses H Cone Memorial Hospital Operating Corporation CurrentSince Sep 13, 2020 Accepting new patients
The Moses H. Cone Memorial Hospital Operating Corporation Past Accepting new patients

Locations

1200 N Elm St
Greensboro, NC 27401
Phone (336) 574-7000

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": "1493683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592179200000",
    "number": "1083140735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 E WENDOVER AVE STE 400",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011207",
            "telephone_number": "336-832-3150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E WENDOVER AVE STE 400",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011207",
            "telephone_number": "336-832-3150",
            "fax_number": "919-966-8419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANVEY",
        "first_name": "INDIA",
        "middle_name": "BLAIRE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-02",
        "last_updated": "2020-06-15",
        "certification_date": "2020-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NC",
            "license": "227073",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2020-00637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.