Individual provider Active NPI

Nicole Sarah McMahon, M.D.

  • Pediatrics Physician
  • Pinehurst, NC
National Provider Identifier
1174766109
Registry record updated Jul 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2014-00237 Issued in NC
Practice address
155 Memorial Dr
Pinehurst, NC 28374-8710
Phone
(504) 391-7585
NPI assigned
Apr 6, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2014

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 MD.203974 LA
Pediatrics Physician 208000000X 2014-00237 NC Primary

Addresses

Primary practice location

155 Memorial Dr
Pinehurst, NC 28374-8710

Mailing address

1 Elk Ridge LN
Southern Pines, NC 28387-5173
Phone (504) 491-0423

Other identifiers 1

IdentifierTypeStateIssuer
1882968MedicaidLA

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
I20141009000926 NC Practitioner - HospitalistPractitioner - Pediatric Medicine 2769647361 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD.203974LAMDPediatrics Physician
2014-00237NCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
FHPG, LLC CurrentSince Jan 1, 2015 Accepting new patients
FHPG, LLC CurrentSince Jan 1, 2015 Accepting new patients
Firsthealth of the Carolinas, Inc Dba Firsthealth-Unc Maternal-Fetal Medicine CurrentSince Sep 1, 2014 Accepting new patients
Firsthealth of the Carolinas, Inc. Current Accepting new patients
FHPG, LLC Current Accepting new patients
Firsthealth of the Carolinas, Inc Dba Firsthealth Weight Management Clinic CurrentSince Sep 1, 2014 Accepting new patients

Locations

923 W 3rd St
Pembroke, NC 28372
Phone (910) 521-0564

46 Memorial Dr
Pinehurst, NC 28374
Phone (910) 295-6782

155 Memorial Dr
Pinehurst, NC 28374
Phone (910) 215-1000

6408 Fayetteville Rd
Raeford, NC 28376
Phone (910) 878-6000

925 S Long Dr
Rockingham, NC 28379
Phone (910) 417-3000

520 Allen St
Troy, NC 27371
Phone (910) 571-5000

Interoperability endpoints

  • Direct secure messaging: nmcmahon13151@firsthealth.direct-ci.net

Organizations & group practices 7

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": "1238976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404259200000",
    "number": "1174766109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ELK RIDGE LN",
            "city": "SOUTHERN PINES",
            "state": "NC",
            "postal_code": "283875173",
            "telephone_number": "504-491-0423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 MEMORIAL DR",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283748710",
            "telephone_number": "504-391-7585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMAHON",
        "first_name": "NICOLE",
        "middle_name": "SARAH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-06",
        "last_updated": "2014-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "MD.203974",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2014-00237",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1882968",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pinehurst, NC

Sources for this page

Verify at the official NPI Registry.