Active NPI
Mireille Liboiron, D.O.
- Pediatric Critical Care Medicine Physician
- Greenville, NC
National Provider Identifier
1376998351
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Critical Care Medicine Physician
- License
- 2022-01891
- Practice address
- 2100 Stantonsburg Rd
Greenville, NC 27834-2818 - Phone
- (252) 744-5871
- Fax
- (252) 744-5759
- NPI assigned
- Apr 27, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Critical Care Medicine Physician | 2080P0203X | 2022-01891 | NC | Primary |
| Pediatrics Physician | 208000000X | E-12302 | AR | |
| Pediatric Critical Care Medicine Physician | 2080P0203X | E-12302 | AR | |
| Pediatric Nurse Practitioner | 363LP0200X | E-12302 | AR |
Addresses
Primary practice location
2100 Stantonsburg Rd
Greenville, NC 27834-2818
Mailing address
PO Box 751069
Charlotte, NC 28275-1069
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mliboiron385206@direct.ecuhealth.com | Health Information Exchange (HIE) |
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2022-01891 | NC | MD | Pediatric Critical Care Medicine Physician |
| E-12302 | AR | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| East Carolina University | Pediatrics | Current | Accepting new patients |
| East Carolina University | Current | Accepting new patients |
Locations
2100 Stantonsburg Rd
Greenville, NC 27834
Phone (252) 744-3229
600 Moye Blvd
Greenville, NC 27834
Phone (252) 744-1111
Organizations & group practices 2
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.
-
- Family Medicine Physician
- Greenville, NC
- NPI 1972551919
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1461715200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708300800000",
"number": "1376998351",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 751069",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282751069"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2100 STANTONSBURG RD",
"city": "GREENVILLE",
"state": "NC",
"postal_code": "278342818",
"telephone_number": "252-744-5871",
"fax_number": "252-744-5759"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIBOIRON",
"first_name": "MIREILLE",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-04-27",
"last_updated": "2024-02-19",
"certification_date": "2024-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0203X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Critical Care Medicine",
"state": "NC",
"license": "2022-01891",
"primary": true
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "AR",
"license": "E-12302",
"primary": false
},
{
"code": "2080P0203X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Critical Care Medicine",
"state": "AR",
"license": "E-12302",
"primary": false
},
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "AR",
"license": "E-12302",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mliboiron385206@direct.ecuhealth.com",
"affiliation": "N",
"endpointDescription": "ECU Physicians",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"address_1": "2100 Stantonsburg Rd",
"city": "Greenville",
"state": "NC",
"country_code": "US",
"postal_code": "278342818",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Greenville, NC
- Tian Li
- Xiaoxian Li, M.D.
- Liaison Out-Patient Behavior Health Resources, LLC
- Liasion Outpatient Complex LLC
- Liberty Hospice House of Greenville, LLC
- Buffa Singleton Lich, RD, LDN, CNSC
- Life Bloom Support & Referral Services LLC
- Lifecare Network Inc
- Lifespring Counseling PLLC
- Brittany Adkins Liggitt, MS, CCC-SLP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.