Individual provider Active NPI

Mary E McKelvey, MD

  • Internal Medicine Physician
  • Beaver, WV
National Provider Identifier
1467446526
Registry record updated Oct 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
15767 Issued in WV
Practice address
1196 Airport Rd
Beaver, WV 25813-9421
Phone
(304) 253-5155
Fax
(304) 252-3471
NPI assigned
Sep 6, 2005
Last updated
Oct 11, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 15767 WV Primary

Addresses

Primary practice location

1196 Airport Rd
Beaver, WV 25813-9421

Mailing address

200 Pocahontas TRL
P.O Box 457
White Sulphur Springs, WV 24986-5026
Phone (304) 536-5030

Other identifiers 1

IdentifierTypeStateIssuer
0072468000MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20071010000549 WV Practitioner - Internal Medicine 5698861375 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Perelman School of Med at the University of Pennsylvania, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Anchor Medical LLCGroup PAC ID 2062635691, 4 clinicians

Practice addresses (Care Compare)

106 Lockheed Dr
Beaver, WV 25813-8962
Phone (304) 253-5155

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15767WVMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain Rooted Behavioral Health LLC CurrentSince Apr 9, 2024 Accepting new patients
Brian S. Love MD, Inc Past Accepting new patients
New River Health Association, Inc. Past Accepting new patients

Locations

106 Lockheed Dr
Beaver, WV 25813
Phone (304) 253-5155

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/6958/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1125964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476144000000",
    "number": "1467446526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 POCAHONTAS TRL",
            "address_2": "P.O BOX 457",
            "city": "WHITE SULPHUR SPRINGS",
            "state": "WV",
            "postal_code": "249865026",
            "telephone_number": "304-536-5030",
            "fax_number": "304-536-5031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1196 AIRPORT RD",
            "city": "BEAVER",
            "state": "WV",
            "postal_code": "258139421",
            "telephone_number": "304-253-5155",
            "fax_number": "304-252-3471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKELVEY",
        "first_name": "MARY",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-06",
        "last_updated": "2016-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WV",
            "license": "15767",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0072468000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaver, WV

Sources for this page

Verify at the official NPI Registry.