Individual provider Active NPI

David Edward Milbourn, MD

  • Pediatrics Physician
  • Charlotte, NC
National Provider Identifier
1124463781
Registry record updated Oct 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
191555 Issued in NC
Practice address
2630 E 7TH St Ste 101
Charlotte, NC 28204-4319
Phone
(704) 384-1000
NPI assigned
May 8, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2020

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 2016-00299 NC
Pediatrics Physician 208000000X 191555 NC Primary

Addresses

Primary practice location

2630 E 7TH St Ste 101
Charlotte, NC 28204-4319

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 384-1000

Other identifiers 2

IdentifierTypeStateIssuer
NC2724MedicaidSC
1124463781MedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dmilbourn440636@direct.novanthealth.org

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
I20160623000125 NC Practitioner - Pediatric Medicine 9234420167 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
191555NCMDPediatrics Physician
2016-00299NCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince May 15, 2017 Accepting new patients
Novant Health Medical Group, LLC Pediatrics CurrentSince May 15, 2017 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

1718 E 4th St
Ste 707
Charlotte, NC 28204
Phone (704) 316-4485

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

517 S Sharon Amity Rd
Charlotte, NC 28211
Phone (704) 384-1406

2630 E 7th St
Ste 101
Charlotte, NC 28204
Phone (704) 344-1000

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Interoperability endpoints

  • Direct secure messaging: dmilbourn440636@direct.novanthealth.org

Organizations & group practices 4

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": "1367971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603756800000",
    "number": "1124463781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "704-384-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2630 E 7TH ST STE 101",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282044319",
            "telephone_number": "704-384-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILBOURN",
        "first_name": "DAVID",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-08",
        "last_updated": "2020-10-27",
        "certification_date": "2020-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2016-00299",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "191555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NC2724",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1124463781",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dmilbourn440636@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "2630 E 7th St Ste 101",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282044319",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.