Individual provider Active NPI

David Michael McCance, D.O.

  • Gastroenterology Physician
  • Charleston, SC
National Provider Identifier
1275639361
Registry record updated Jun 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
5101007200 Issued in MI
Practice address
9302 Medical Plaza Dr
Suite B
Charleston, SC 29406-9142
Phone
(843) 553-8730
Fax
(843) 553-8767
NPI assigned
Sep 15, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 5101007200 MI Primary
Gastroenterology Physician 207RG0100X 1233 SC

Addresses

Primary practice location

9302 Medical Plaza Dr
Suite B
Charleston, SC 29406-9142

Mailing address

9302 Medical Plaza Dr
Suite B
Charleston, SC 29406-9142
Phone (843) 553-8730

Other identifiers 3

IdentifierTypeStateIssuer
1404919MedicaidMI
54600105OtherMIBCBS-MI
2909004MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20040303000704 MI Practitioner - GastroenterologyPractitioner - Internal Medicine 2860387800 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101007200MIMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Marquette Physician Practices Inc CurrentSince Dec 12, 2016 Accepting new patients
DLP Marquette Physician Practices Inc CurrentSince Dec 12, 2016 Accepting new patients
David Michael McCance, LLC Gastroenterology Past Accepting new patients

Locations

1414 W Fair Ave
Ste 36
Marquette, MI 49855
Phone (906) 225-3864

107 W Main St
Marquette, MI 49855
Phone (906) 225-3988

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277078400000",
    "number": "1275639361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9302 MEDICAL PLAZA DR",
            "address_2": "SUITE B",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294069142",
            "telephone_number": "843-553-8730",
            "fax_number": "843-553-8767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9302 MEDICAL PLAZA DR",
            "address_2": "SUITE B",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294069142",
            "telephone_number": "843-553-8730",
            "fax_number": "843-553-8767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCANCE",
        "first_name": "DAVID",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2010-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MI",
            "license": "5101007200",
            "primary": true
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "SC",
            "license": "1233",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1404919",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS-MI",
            "identifier": "54600105",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2909004",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.