Individual provider Active NPI

Anjanette Laurice McIlwain, MD

  • Pediatrics Physician
  • Fayetteville, NC
National Provider Identifier
1164405189
Registry record updated Jul 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
200200411 Issued in NC
Practice address
6387 Ramsey St
Suite 240
Fayetteville, NC 28311-9441
Phone
(910) 615-3960
Fax
(910) 486-2159
NPI assigned
Nov 23, 2005
Last updated
Jul 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 200200411 NC Primary

Addresses

Primary practice location

6387 Ramsey St
Suite 240
Fayetteville, NC 28311-9441

Mailing address

6387 Ramsey St
Suite 240
Fayetteville, NC 28311-9441
Phone (910) 615-3960

Other practice location 1

300 Medical Pavilion Dr Ste 150
Raeford, NC 28376-0030
Phone (910) 904-8025

Other practice location 2

1262 Oliver St Ste B
Fayetteville, NC 28304-4449
Phone (910) 615-4801

Other practice location 3

210 Medical Pavilion Dr
Raeford, NC 28376-9111
Phone (910) 904-8000

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
I20210701002411 NC Practitioner - Pediatric Medicine 4688075369 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200200411NCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hoke Healthcare, LLC Current Accepting new patients
Hoke Healthcare LLC CurrentSince Jul 1, 2021 Accepting new patients
Cumberland County Hospital System Inc Pediatrics Past Accepting new patients

Locations

300 Medical Pavilion Dr
#15
Raeford, NC 28376
Phone (910) 904-8020

300 Medical Pavilion Dr
Ste 150
Raeford, NC 28376
Phone (910) 904-8020

Interoperability endpoints

  • Direct secure messaging: amcilwainmccollum10254@capefearvalley.direct-ci.com

Organizations & group practices 3

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1132704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785283200000",
    "number": "1164405189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6387 RAMSEY ST",
            "address_2": "SUITE 240",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283119441",
            "telephone_number": "910-615-3960",
            "fax_number": "910-486-2159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6387 RAMSEY ST",
            "address_2": "SUITE 240",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283119441",
            "telephone_number": "910-615-3960",
            "fax_number": "910-486-2159"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Medical Pavilion Dr Ste 150",
            "address_purpose": "LOCATION",
            "city": "Raeford",
            "state": "NC",
            "postal_code": "283760030",
            "country_code": "US",
            "telephone_number": "910-904-8025",
            "fax_number": "910-615-9751",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1262 Oliver St Ste B",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283044449",
            "country_code": "US",
            "telephone_number": "910-615-4801",
            "fax_number": "910-615-5406",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "210 Medical Pavilion Dr",
            "address_purpose": "LOCATION",
            "city": "Raeford",
            "state": "NC",
            "postal_code": "283769111",
            "country_code": "US",
            "telephone_number": "910-904-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCILWAIN",
        "first_name": "ANJANETTE",
        "middle_name": "LAURICE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-23",
        "last_updated": "2026-07-29",
        "certification_date": "2026-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "200200411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.