Richard M Pavelock, MD

Primary specialty

Addiction Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084A0401X

License

39460 Issued in NC

Practice address

2632 Fines Creek Dr
Statesville, NC 28625-4441

Phone

(704) 838-0516

Fax

(704) 838-0565

NPI assigned

Oct 26, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 3

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: richard-pavelock-1@randylongmd.e-mdsdirect.com
• Direct secure messaging: richard-pavelock@randylongmd.e-mdsdirect.com

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.

• Rapha Healthcare Services,LLC

  • Multi-Specialty Clinic/Center
  • Durham, NC
  • NPI 1316335128
  Medicare reassignment NPD
• Vitality Medical Services, PLLC

  • General Practice Physician
  • Statesville, NC
  • NPI 1508237496
  NPD (past) Authorized official

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1487739579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2632 FINES CREEK DR",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286254441",
            "telephone_number": "704-838-0516",
            "fax_number": "704-838-0565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2632 FINES CREEK DR",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286254441",
            "telephone_number": "704-838-0516",
            "fax_number": "704-838-0565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAVELOCK",
        "first_name": "RICHARD",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "39460",
            "primary": false
        },
        {
            "code": "2084P0005X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurodevelopmental Disabilities",
            "state": "NC",
            "license": "39460",
            "primary": false
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "NC",
            "license": "39460",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "39460",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00219696",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8966248",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "66248",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paths for Success, LLC
• Paths to Success
• Paths to Success, LLC
• Paula McNutt Patterson, LCSWA
• Anna Leigh Paulin, LCSWA
• Payne Chiropractic Center PA
• Jeffrey E Payne, DC
• Sara Paz
• Lisa Marie Peggs, PT
• Diane Setzer Pemberton, RN

• Addiction Medicine (Psychiatry & Neurology) Physician in Statesville, NC
• Providers in Statesville, NC by specialty
• Addiction Medicine (Psychiatry & Neurology) Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 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.

Verify at the official NPI Registry.