Individual provider Active NPI

Kevin Francis McEnaney, MD

  • Pediatrics Physician
  • Clayton, NC
National Provider Identifier
1093716482
Registry record updated Mar 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2009-00440 Issued in NC
Practice address
500 Gateway Dr
Clayton, NC 27520-2158
Phone
(919) 585-9001
Fax
(919) 488-1719
NPI assigned
Aug 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 225335 NY
Pediatrics Physician 208000000X 2009-00440 NC Primary

Addresses

Primary practice location

500 Gateway Dr
Clayton, NC 27520-2158

Mailing address

260 Horizon Dr
Raleigh, NC 27615-4922
Phone (919) 488-0015

Other identifiers 2

IdentifierTypeStateIssuer
5913630MedicaidNC
01408951MedicaidNY

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
I20180718002741 NC Practitioner - Pediatric Medicine 0749537009 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2009-00440NCMDPediatrics Physician
225335NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Duke Health Integrated Practice, Inc. CurrentSince Jul 1, 2023 Accepting new patients

Locations

500 Gateway Dr
Clayton, NC 27520
Phone (919) 488-0015

40 Duke Medicine Cir
Durham, NC 27710
Phone (919) 681-6588

1005 Big Oak Ct
Knightdale, NC 27545
Phone (919) 266-5669

260 Horizon Dr
Raleigh, NC 27615
Phone (919) 488-0015

270 Horizon Dr
Raleigh, NC 27615
Phone (919) 488-0015

11130 Capital Blvd
Wake Forest, NC 27587
Phone (919) 488-4094

116 E Horton St
Zebulon, NC 27597
Phone (919) 269-2885

Interoperability endpoints

  • Direct secure messaging: kmcenaney400192@direct.medicine.duke.edu

Organizations & group practices 1

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": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362960000000",
    "number": "1093716482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 HORIZON DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276154922",
            "telephone_number": "919-488-0015",
            "fax_number": "919-277-0066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 GATEWAY DR",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275202158",
            "telephone_number": "919-585-9001",
            "fax_number": "919-488-1719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCENANEY",
        "first_name": "KEVIN",
        "middle_name": "FRANCIS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2013-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "225335",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2009-00440",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5913630",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01408951",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clayton, NC

Sources for this page

Verify at the official NPI Registry.