Individual provider Active NPI

Peggy Doleen McMillen, PA-C

  • Physician Assistant
  • New Bern, NC
National Provider Identifier
1265514673
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
103096 Issued in NC
Practice address
1020 Medical Park Ave
New Bern, NC 28562-5248
Phone
(252) 514-6685
Fax
(252) 514-2745
NPI assigned
Oct 19, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 103096 NC Primary
Medical Physician Assistant 363AM0700X 103096 NC

Addresses

Primary practice location

1020 Medical Park Ave
New Bern, NC 28562-5248

Mailing address

1020 Medical Park Ave
New Bern, NC 28562-5248
Phone (252) 514-6685

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
103096NCMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Nova Urgent Care Pamlico PA Physician Assistant CurrentSince Aug 15, 2018 Accepting new patients
Nova Urgent Care Carteret, P.a. CurrentSince Aug 15, 2018 Accepting new patients
Extended Care Physicians - Mountain, PA Physician Assistant PastSince Aug 1, 2012 Accepting new patients
Extended Care Physicians - Metrolina PA Past Accepting new patients
Nova Urgent & Medical Care, P.a. Past Accepting new patients

Locations

4252 Arendell St
Ste A
Morehead City, NC 28557
Phone (252) 222-0204

1813 S Glenburnie Rd
New Bern, NC 28562
Phone (252) 672-0095

Organizations & group practices 5

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": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1265514673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 MEDICAL PARK AVE",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285625248",
            "telephone_number": "252-514-6685",
            "fax_number": "252-514-2745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 MEDICAL PARK AVE",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285625248",
            "telephone_number": "252-514-6685",
            "fax_number": "252-514-2745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMILLEN",
        "first_name": "PEGGY",
        "middle_name": "DOLEEN",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-19",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "103096",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "103096",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Bern, NC

Sources for this page

Verify at the official NPI Registry.