NPIMap

Individual provider Active NPI

Robert Howard McConville Jr., MD

  • Family Medicine Physician
  • Sanford, NC
National Provider Identifier
1104820133
Registry record updated Jun 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20316 Issued in NC
Practice address
1125 Carthage St
Sanford, NC 27330-4162
Phone
(919) 774-6023
Fax
(919) 776-6359
NPI assigned
Jun 8, 2005
Sex
Male
Sole proprietor
No

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.

Hospital & facility affiliations 9

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

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Indiana University School of Medicine, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DLP Central Carolina Medical Group LLC 38 clinicians

Practice addresses (Care Compare)

101 Church St
Broadway, NC 27505-9394
Phone (919) 258-6521

Hospital & facility affiliations

  • Liberty Home Care Home health agency, Siler City, NC, CCN 347309
  • Amedisys Home Health of Chapel Hill Home health agency, Chapel Hill, NC, CCN 347030
  • Central Carolina Hospital Hospital, Sanford, NC, CCN 340020
  • Firsthealth Moore Regional Hospital Hospital, Pinehurst, NC, CCN 340115
  • Unc Hospitals Hospital, Chapel Hill, NC, CCN 340061

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20050824000063 NC Practitioner - Family Practice 5294639126 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Central Carolina Medical Group LLC CurrentSince May 1, 2017 Accepting new patients
DLP Central Carolina Medical Group LLC Family Medicine CurrentSince May 1, 2017 Accepting new patients
DLP Central Carolina Medical Group LLC Current Accepting new patients

Locations

101 Church St
Broadway, NC 27505
Phone (919) 258-6521

75 Old Graham Rd
Pittsboro, NC 27312
Phone (919) 542-2731

1125 Carthage St
Sanford, NC 27330
Phone (919) 774-6023

4546 NC 87 S
Sanford, NC 27332
Phone (919) 499-5151

330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780

Interoperability endpoints

  • Direct secure messaging: robert.mcconville.1@15593.direct.athenahealth.com
  • Direct secure messaging: robert.mcconville.1@23663.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/15593/brand/16/csg/1/fhir/r4

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20316 NC Primary

Addresses

NPPES NPI Registry

Primary practice location

1125 Carthage St
Sanford, NC 27330-4162

Mailing address

1125 Carthage St
Sanford, NC 27330-4162
Phone (919) 774-6023

Other identifiers 8

NPPES NPI Registry
IdentifierTypeStateIssuer
412013354OtherNCRR MEDICARE
0138851OtherNCUNITED HEALTHCARE
270326OtherNCMAMSI
133545617OtherNCTRICARE
8955856MedicaidNC
3913OtherNCPARTNERS
27772OtherNCMEDCOST
55856OtherNCBCBS

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 23, 2022.

{
    "created_epoch": "1118188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655942400000",
    "number": "1104820133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 CARTHAGE ST",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "273304162",
            "telephone_number": "919-774-6023",
            "fax_number": "919-776-6359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 CARTHAGE ST",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "273304162",
            "telephone_number": "919-774-6023",
            "fax_number": "919-776-6359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCONVILLE",
        "first_name": "ROBERT",
        "middle_name": "HOWARD",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-08",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "20316",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "412013354",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0138851",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "270326",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "133545617",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8955856",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARTNERS",
            "identifier": "3913",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "27772",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "55856",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sanford, NC

Sources for this page

Verify at the official NPI Registry.