Individual provider Active NPI

Marilu Thordsen-Velez, MD

  • Pediatrics Physician
  • Durham, NC
National Provider Identifier
1245275528
Registry record updated Jan 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2011-00158 Issued in NC
Practice address
2100 Erwin Rd
Durham, NC 27705-3941
Phone
(919) 684-8111
NPI assigned
Jun 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 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 MD00046451 WA
Pediatrics Physician 208000000X 2011-00158 NC Primary

Addresses

Primary practice location

2100 Erwin Rd
Durham, NC 27705-3941

Mailing address

PO Box 63362
Charlotte, NC 28263-3362
Phone (919) 684-8111

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
I20140221000536 NC Practitioner - Pediatric MedicinePractitioner - Internal Medicine 8123194545 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00046451WAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Maria Parham Physician Practices, LLC CurrentSince Nov 1, 2024 Accepting new patients
Hospital Physician Services - Southeast Professional Corporation CurrentSince Sep 1, 2023 Accepting new patients
Emergency Coverage, LLC CurrentSince Sep 15, 2023 Accepting new patients
DLP Maria Parham Physician Practices, LLC Current Accepting new patients
DLP Maria Parham Physician Practices LLC CurrentSince Nov 1, 2024 Accepting new patients
Scotland Memorial Hospital Inc CurrentSince Dec 1, 2022 Accepting new patients
Scotland Memorial Hospital Inc Pediatrics CurrentSince Dec 1, 2022 Accepting new patients

Locations

566 Ruin Creek Rd
Henderson, NC 27536
Phone (252) 436-1352

511 Ruin Creek Rd
Ste 101
Henderson, NC 27536
Phone (252) 436-0440

120 Charles Rollins Rd
Ste 105
Henderson, NC 27536
Phone (252) 438-2773

500 Lauchwood Dr
Laurinburg, NC 28352
Phone (856) 848-3227

2460 Curtis Ellis Dr
Rocky Mount, NC 27804
Phone (252) 443-8199

615 Ridge Rd
Roxboro, NC 27573
Phone (336) 503-5699

288 S Ridgecrest Ave
Rutherfordton, NC 28139
Phone (252) 808-6000

1135 Carthage St
Sanford, NC 27330
Phone (910) 774-2100

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": "1150675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389657600000",
    "number": "1245275528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 63362",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282633362",
            "telephone_number": "919-684-8111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 ERWIN RD",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277053941",
            "telephone_number": "919-684-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORDSEN-VELEZ",
        "first_name": "MARILU",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-19",
        "last_updated": "2014-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD00046451",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2011-00158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.