Active NPI
Keith Van Allen Nance, MD
- Anatomic Pathology & Clinical Pathology Physician
- Raleigh, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- 31052
- Practice address
- 4420 Lake Boone TRL
Raleigh, NC 27607-7505 - Phone
- (919) 783-3286
- Fax
- (919) 783-3363
- NPI assigned
- Feb 28, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cytopathology Physician | 207ZC0500X | 31052 | NC | |
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 31052 | NC | Primary |
Addresses
Primary practice location
4420 Lake Boone TRL
Raleigh, NC 27607-7505
Mailing address
PO Box 100559
Florence, SC 29501-0559
Phone (843) 664-4300
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 61786 | Other | NC | BCBS |
| 8961786 | Medicaid | NC |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Pathology
- Education
- Brody School of Medicine at East Carolina University, 1985
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4420 Lake Boone TRL
Raleigh, NC 27607-7505
Phone (919) 784-3063
Hospital & facility affiliations
- Rex Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 94.87 of 100
- Quality
- 99.47
- Improvement activities
- 40
- Cost
- 83.62
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31052 | NC | MD | Anatomic Pathology & Clinical Pathology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rex Pathology Associates PA | Cytopathology | Current | Accepting new patients |
Locations
4420 Lake Boone Trl
Raleigh, NC 27607
Phone (919) 784-3034
5700 Southwyck Blvd
Toledo, OH 43614
Organizations & group practices 1
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.
-
- Anatomic Pathology & Clinical Pathology Physician
- Raleigh, NC
- NPI 1255307187
Cytopathology
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Raleigh, NC
- NPI 1497797088
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141084800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200355200000",
"number": "1376519280",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 100559",
"city": "FLORENCE",
"state": "SC",
"postal_code": "295010559",
"telephone_number": "843-664-4300",
"fax_number": "843-664-4308"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4420 LAKE BOONE TRL",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276077505",
"telephone_number": "919-783-3286",
"fax_number": "919-783-3363"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NANCE",
"first_name": "KEITH",
"middle_name": "VAN ALLEN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-28",
"last_updated": "2008-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "207ZC0500X",
"taxonomy_group": "",
"desc": "Pathology, Cytopathology",
"state": "NC",
"license": "31052",
"primary": false
},
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "NC",
"license": "31052",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "61786",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8961786",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.