Individual provider Active NPI

Richard A McNeilly, DO, FCCP

  • Pulmonary Disease Physician
  • Madison, WV
National Provider Identifier
1093087611
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
3010 Issued in TN
Practice address
701 Madison Ave
Madison, WV 25130-1669
Phone
(304) 369-1230
NPI assigned
Jan 27, 2012
Last updated
Nov 12, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 3010 TN
Internal Medicine Physician 207R00000X T-2337 MS
Pulmonary Disease Physician 207RP1001X 58-004978 OH
Pulmonary Disease Physician 207RP1001X 115288 MT
Pulmonary Disease Physician 207RP1001X 90050 SC
Pulmonary Disease Physician 207RP1001X 3010 TN Primary

Addresses

Primary practice location

701 Madison Ave
Madison, WV 25130-1669

Mailing address

32 Recter LN
South Charleston, WV 25309-9663
Phone (704) 300-9443

Other practice location 1

2205 Pavilion Dr
Suite 201B
Kingsport, TN 37660
Phone (423) 857-7650

Other practice location 2

350 Heritage Way Ste 2100
Kalispell, MT 59901-3167
Phone (406) 257-8992

Other practice location 3

125 Professional Park Dr
Seneca, SC 29678-2558
Phone (864) 482-3000

Other practice location 4

1130 W 4th St Ste 2001
Lawrence, KS 66044-1345
Phone (785) 505-3205

Other practice location 5

1130 W 4th St Ste 2050
Lawrence, KS 66044-1333
Phone (785) 505-3205

Other identifiers 3

IdentifierTypeStateIssuer
30005177140001MedicaidKS
Q022431MedicaidTN
1093087611MedicaidVA

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address DEPTLHREVIntegrityHIMTechs@logan.org Kalispell Regional Medical Center Inc
Direct Messaging Address richard.mcneilly@direct.lmh.org Direct
Direct Messaging Address richard.mcneilly@direct.lmh.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, SC, OH, KS4 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 4

Enrollment IDStateProvider typePAC IDDetails
I20201210002309 WV Practitioner - Pulmonary Disease 0547568586 Reassigns benefits to 4 organizations
I20230915002907 SC Practitioner - Pulmonary Disease 0547568586 Reassigns benefits to 1 organization
I20240729002912 OH Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 0547568586 Reassigns benefits to 1 organization
I20240822000467 KS Practitioner - Pulmonary Disease 0547568586 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lawrence Physicians LLCGroup PAC ID 1951623834, 223 clinicians
Genesis Medical Group, LLCGroup PAC ID 7719040385, 265 clinicians

Practice addresses (Care Compare)

1130 W 4TH St
2001 Lawrence Pulmonary Specialists
Lawrence, KS 66044-1328
Phone (785) 505-3205

945 Bethesda Dr
Suite 260
Zanesville, OH 43701-1880
Phone (740) 454-4788

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3649WVMDGeneral Practice Dentistry
T-2337MSMDInternal Medicine Physician
58-004978OHMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Sep 11, 2023 Accepting new patients
Genesis Medical Group LLC Internal Medicine CurrentSince Jul 11, 2024 Accepting new patients
Genesis Medical Group, LLC CurrentSince Jul 11, 2024 Accepting new patients
Blue Ridge Medical Management Corporation Current Accepting new patients
Lawrence Physicians LLC Pulmonary Disease CurrentSince Aug 19, 2024 Accepting new patients
Boone Memorial Hospital, Inc CurrentSince Jan 4, 2021 Accepting new patients
Prisma Health University Medical Group Internal Medicine CurrentSince Sep 11, 2023 Accepting new patients
Hospitalist Medicine Physicians of West Virginia- TCG PLLC Internal Medicine CurrentSince Jun 24, 2022 Accepting new patients
Boone Memorial Hospital, Inc CurrentSince Jan 4, 2021 Accepting new patients
Lawrence Physicians LLC CurrentSince Aug 19, 2024 Accepting new patients
Boone Memorial Hospital, Inc Current Accepting new patients
Lawrence Physicians LLC Current Accepting new patients
Boone Memorial Hospital, Inc Internal Medicine Current Accepting new patients
Blue Ridge Medical Management Corporation Pulmonary Disease Past Accepting new patients
Lawrence Memorial Hospital Past Accepting new patients

Locations

1130 W 4th St
Ste 2001
Lawrence, KS 66044
Phone (785) 505-3205

1130 W 4th St
Ste 2050
Lawrence, KS 66044
Phone (785) 505-3636

325 Maine St
Lawrence, KS 66044
Phone (785) 505-2988

2951 Maple Ave
Zanesville, OH 43701
Phone (740) 454-4000

945 Bethesda Dr
Ste 200
Zanesville, OH 43701
Phone (740) 454-4788

945 Bethesda Dr
Ste 260
Zanesville, OH 43701
Phone (740) 450-4180

945 Bethesda Dr
Ste 330
Zanesville, OH 43701
Phone (740) 454-4038

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

2A Cleveland Ct
Greenville, SC 29607
Phone (864) 271-7761

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

125 Professional Park Dr
Seneca, SC 29678
Phone (864) 482-3000

1021 W Oakland Ave
Ste 310
Johnson City, TN 37604
Phone (423) 302-6565

701 Madison Ave
Madison, WV 25130
Phone (304) 369-1230

4605 Maccorkle Ave SW
South Charleston, WV 25309
Phone (304) 414-4800

Interoperability endpoints

  • Direct secure messaging: richard.mcneilly@direct.lmh.org
  • Direct secure messaging: rmcneilly351418@direct.wvuhsdirect.com

Organizations & group practices 17

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.

View all 17

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1327622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1093087611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 RECTER LN",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253099663",
            "telephone_number": "704-300-9443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 MADISON AVE",
            "city": "MADISON",
            "state": "WV",
            "postal_code": "251301669",
            "telephone_number": "304-369-1230"
        }
    ],
    "practiceLocations": [
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            "address_1": "2205 Pavilion Dr",
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            "address_purpose": "LOCATION",
            "city": "Kingsport",
            "state": "TN",
            "postal_code": "37660",
            "country_code": "US",
            "telephone_number": "423-857-7650",
            "fax_number": "423-857-7655",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "350 Heritage Way Ste 2100",
            "address_purpose": "LOCATION",
            "city": "Kalispell",
            "state": "MT",
            "postal_code": "599013167",
            "country_code": "US",
            "telephone_number": "406-257-8992",
            "fax_number": "406-257-8996",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "125 Professional Park Dr",
            "address_purpose": "LOCATION",
            "city": "Seneca",
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            "postal_code": "296782558",
            "country_code": "US",
            "telephone_number": "864-482-3000",
            "fax_number": "864-482-4000",
            "country_name": "United States",
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        },
        {
            "address_1": "1130 W 4th St Ste 2001",
            "address_purpose": "LOCATION",
            "city": "Lawrence",
            "state": "KS",
            "postal_code": "660441345",
            "country_code": "US",
            "telephone_number": "785-505-3205",
            "fax_number": "785-505-5261",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1130 W 4th St Ste 2050",
            "address_purpose": "LOCATION",
            "city": "Lawrence",
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            "postal_code": "660441333",
            "country_code": "US",
            "telephone_number": "785-505-3205",
            "fax_number": "785-505-5261",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCNEILLY",
        "first_name": "RICHARD",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DO, FCCP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-01-27",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "3010",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "T-2337",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "OH",
            "license": "58-004978",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MT",
            "license": "115288",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "SC",
            "license": "90050",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "TN",
            "license": "3010",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30005177140001",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q022431",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093087611",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "DEPTLHREVIntegrityHIMTechs@logan.org",
            "affiliation": "Y",
            "affiliationName": "Kalispell Regional Medical Center Inc",
            "address_1": "350 Heritage Way Ste 2100",
            "city": "Kalispell",
            "state": "MT",
            "country_code": "US",
            "postal_code": "599013167",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "richard.mcneilly@direct.lmh.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1130 W 4th St Ste 2001",
            "city": "Lawrence",
            "state": "KS",
            "country_code": "US",
            "postal_code": "660441345",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "richard.mcneilly@direct.lmh.org",
            "affiliation": "N",
            "endpointDescription": "Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1130 W 4th St Ste 2050",
            "city": "Lawrence",
            "state": "KS",
            "country_code": "US",
            "postal_code": "660441333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Madison, WV

Sources for this page

Verify at the official NPI Registry.