Active NPI
Kenneth Charles Marburg, MD
- Emergency Medicine Physician
- Wilmington, NC
National Provider Identifier
1144225558
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 27706
- Practice address
- 4402 Shipyard Blvd
Wilmington, NC 28403-6161 - Phone
- (910) 452-1400
- Fax
- (910) 332-1072
- NPI assigned
- Jun 14, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 27706 | NC | Primary |
| General Practice Physician | 208D00000X | 27706 | NC |
Addresses
Primary practice location
4402 Shipyard Blvd
Wilmington, NC 28403-6161
Mailing address
4402 Shipyard Blvd
Wilmington, NC 28403-6161
Phone (910) 452-1400
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 53962 | Other | NC | BCBS |
| 27492 | Other | NC | MEDCOST |
| 110127021 | Other | NC | RAILROAD MEDICARE |
| 01-28858 | Other | NC | UNITED HEALTHCARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27706 | NC | MD | Emergency Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1258329600000",
"number": "1144225558",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4402 SHIPYARD BLVD",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284036161",
"telephone_number": "910-452-1400",
"fax_number": "910-332-1072"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4402 SHIPYARD BLVD",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284036161",
"telephone_number": "910-452-1400",
"fax_number": "910-332-1072"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARBURG",
"first_name": "KENNETH",
"middle_name": "CHARLES",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-14",
"last_updated": "2009-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "NC",
"license": "27706",
"primary": true
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "NC",
"license": "27706",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "53962",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDCOST",
"identifier": "27492",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "110127021",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "01-28858",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wilmington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.