Individual provider Active NPI

Megan Diane Mikkelson, MD

  • Family Medicine Physician
  • Greenville, NC
National Provider Identifier
1578212890
Registry record updated Aug 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2023-03018 Issued in NC
Practice address
2160 Herbert CT
Greenville, NC 27834-3736
Phone
(252) 744-3850
Fax
(252) 744-3894
NPI assigned
Mar 23, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 310140 NC
Family Medicine Physician 207Q00000X 2023-03018 NC Primary

Addresses

Primary practice location

2160 Herbert CT
Greenville, NC 27834-3736

Mailing address

PO Box 751069
Charlotte, NC 28275-1069

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mmikkelson527034@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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250828001306 NC Practitioner - Family Practice 6002296688 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Carolina UniversityGroup PAC ID 0244143246, 499 clinicians

Practice addresses (Care Compare)

2160 Herbert CT
Greenville, NC 27834-3736
Phone (252) 744-3850

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2023-03018NCMDFamily Medicine Physician
310140NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
East Carolina University Multi-Specialty Current Accepting new patients
Vidant Medical Group LLC Multi-Specialty CurrentSince Aug 8, 2025 Accepting new patients
East Carolina University Multi-Specialty CurrentSince Aug 11, 2025 Accepting new patients
East Carolina University Multi-Specialty Past Accepting new patients

Locations

2160 Herbert Ct
Greenville, NC 27834
Phone (252) 744-3850

600 Moye Blvd
Greenville, NC 27834
Phone (252) 744-1111

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

2704 N Main St
Tarboro, NC 27886
Phone (252) 823-6333

Interoperability endpoints

  • Direct secure messaging: mmikkelson527034@direct.ecuhealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1647993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756080000000",
    "number": "1578212890",
    "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": "2160 HERBERT CT",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278343736",
            "telephone_number": "252-744-3850",
            "fax_number": "252-744-3894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKKELSON",
        "first_name": "MEGAN",
        "middle_name": "DIANE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-23",
        "last_updated": "2025-08-25",
        "certification_date": "2025-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "310140",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2023-03018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmikkelson527034@direct.ecuhealth.com",
            "affiliation": "N",
            "endpointDescription": "ECU Physicians",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2160 Herbert Ct",
            "city": "Greenville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "278343736",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

Verify at the official NPI Registry.