Individual provider Active NPI

Peter F McIlveen, M.D.

  • Obstetrics Physician
  • Elkin, NC
National Provider Identifier
1124192737
Registry record updated Dec 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics PhysicianTaxonomy code 207VX0000X
License
2003-00501 Issued in NC
Practice address
942 Johnson Ridge Rd
Elkin, NC 28621-2212
Phone
(336) 526-3500
Fax
(336) 526-3508
NPI assigned
Nov 17, 2006
Last updated
Dec 15, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics Physician 207VX0000X 2003-00501 NC Primary

Addresses

Primary practice location

942 Johnson Ridge Rd
Elkin, NC 28621-2212

Mailing address

942 Johnson Ridge Rd
Elkin, NC 28621-2212
Phone (336) 526-3500

Other identifiers 1

IdentifierTypeStateIssuer
8913340MedicaidNC

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
I20050425000066 NC Practitioner - Obstetrics/Gynecology 9739154865 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Connecticut School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

942 Johnson Ridge Rd
Elkin, NC 28621-2212
Phone (336) 526-3500

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2003-00501NCMDObstetrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Total Woman Care, LLC Obstetrics CurrentSince Apr 1, 2006 Accepting new patients

Locations

942 Johnson Ridge Rd
Elkin, NC 28621
Phone (336) 526-3500

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/25603/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir-usa.unify.chbase.com/org/hughcha-dbab3312
  • Direct secure messaging: peter.mc.ilveen.1@25603.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323907200000",
    "number": "1124192737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "942 JOHNSON RIDGE RD",
            "city": "ELKIN",
            "state": "NC",
            "postal_code": "286212212",
            "telephone_number": "336-526-3500",
            "fax_number": "336-526-3508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "942 JOHNSON RIDGE RD",
            "city": "ELKIN",
            "state": "NC",
            "postal_code": "286212212",
            "telephone_number": "336-526-3500",
            "fax_number": "336-526-3508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCILVEEN",
        "first_name": "PETER",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2011-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "NC",
            "license": "2003-00501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8913340",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkin, NC

Sources for this page

Verify at the official NPI Registry.