Individual provider Active NPI

Neill H. Musselwhite III, M.D.

  • Family Medicine Physician
  • Wilmington, NC
National Provider Identifier
1528007226
Registry record updated Jul 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20169 Issued in NC
Practice address
5145 S College Rd
Wilmington, NC 28412-2207
Phone
(910) 792-1144
Fax
(910) 792-0160
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20169 NC Primary

Addresses

Primary practice location

5145 S College Rd
Wilmington, NC 28412-2207

Mailing address

PO Box 602484
Charlotte, NC 28260-2484
Phone (910) 792-1144

Other identifiers 2

IdentifierTypeStateIssuer
1528007226MedicaidNC
8961634MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20169NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bladen Healthcare LLC Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436400000000",
    "number": "1528007226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 602484",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282602484",
            "telephone_number": "910-792-1144",
            "fax_number": "910-792-0160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5145 S COLLEGE RD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284122207",
            "telephone_number": "910-792-1144",
            "fax_number": "910-792-0160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSSELWHITE",
        "first_name": "NEILL",
        "middle_name": "H.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2015-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "20169",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1528007226",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8961634",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.