Individual provider Active NPI

Debra Reid McCutcheon

  • Anesthesiology Physician
  • Morehead City, NC
National Provider Identifier
1184804411
Registry record updated Mar 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
2009-01072 Issued in NC
Practice address
5053 Executive Dr
Ste B
Morehead City, NC 28557-2506
Phone
(336) 716-2255
NPI assigned
Nov 3, 2007
Last updated
Mar 6, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 2009-01072 NC Primary

Addresses

Primary practice location

5053 Executive Dr
Ste B
Morehead City, NC 28557-2506

Mailing address

5053 Executive Dr
Ste B
Morehead City, NC 28557-2506
Phone (336) 716-2255

Other identifiers 2

IdentifierTypeStateIssuer
1184804411MedicaidVA
Q0107RMedicaidSC

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
I20110606000731 NC Practitioner - AnesthesiologyPractitioner - Pain Management 2062699754 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Pain Management
Education
University of South Carolina School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Carolina Anesthesia Associates PLLCGroup PAC ID 5092720813, 691 clinicians
Crystal Coast Pain Management Center, PLLCGroup PAC ID 7315921236, 5 clinicians

Practice addresses (Care Compare)

1001 W Williams St
Suite 103
Apex, NC 27502-3978
Phone (919) 439-7867

5053 Executive Dr
Suite B
Morehead City, NC 28557-2506
Phone (252) 726-8480

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
East Carolina Anesthesia Associates, PLLC Anesthesiology CurrentSince Dec 15, 2024 Accepting new patients
Wake Forest University Health Sciences Past Accepting new patients

Locations

1001 W Williams St
Ste 103
Apex, NC 27502
Phone (919) 363-2111

2430 Emerald Pl
Ste 103
Greenville, NC 27834
Phone (252) 752-2140

57 Office Park Dr
Jacksonville, NC 28546
Phone (910) 353-6008

5053 Executive Dr
Ste B
Morehead City, NC 28557
Phone (252) 636-0300

2111 Neuse Blvd
Ste J
New Bern, NC 28560
Phone (252) 636-0300

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.

Hospital & facility affiliations 1

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": "1194048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488758400000",
    "number": "1184804411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5053 EXECUTIVE DR",
            "address_2": "STE B",
            "city": "MOREHEAD CITY",
            "state": "NC",
            "postal_code": "285572506",
            "telephone_number": "336-716-2255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5053 EXECUTIVE DR",
            "address_2": "STE B",
            "city": "MOREHEAD CITY",
            "state": "NC",
            "postal_code": "285572506",
            "telephone_number": "336-716-2255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCUTCHEON",
        "first_name": "DEBRA",
        "middle_name": "REID",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-03",
        "last_updated": "2017-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NC",
            "license": "2009-01072",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1184804411",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q0107R",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morehead City, NC

Sources for this page

Verify at the official NPI Registry.