Individual provider Active NPI

Matthew R Ledoux, M.D.

  • Pediatric Critical Care Medicine Physician
  • Greenville, NC
National Provider Identifier
1649473299
Registry record updated Feb 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
2011-00581 Issued in NC
Practice address
600 Moye Blvd
Greenville, NC 27834-4300
Phone
(252) 744-0766
Fax
(252) 744-0392
NPI assigned
Jun 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Critical Care Medicine Physician 2080P0203X 2011-00581 NC Primary
Pediatric Critical Care Medicine Physician 2080P0203X 0101241291 VA

Addresses

Primary practice location

600 Moye Blvd
Greenville, NC 27834-4300

Mailing address

PO Box 751069
Charlotte, NC 28275-1069

Other identifiers 2

IdentifierTypeStateIssuer
5917922MedicaidNC
163XHOtherNCBCBS NC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mledoux14077@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
I20110728000144 NC Practitioner - Pediatric Medicine 5193913465 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2011-00581NCMDPediatric Critical Care Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
East Carolina University CurrentSince Jul 5, 2011 Accepting new patients
East Carolina University Current Accepting new patients

Locations

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

Interoperability endpoints

  • Direct secure messaging: mledoux14077@direct.ecuhealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1181260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708300800000",
    "number": "1649473299",
    "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": "600 MOYE BLVD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278344300",
            "telephone_number": "252-744-0766",
            "fax_number": "252-744-0392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEDOUX",
        "first_name": "MATTHEW",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-08",
        "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": "2011-00581",
            "primary": true
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "VA",
            "license": "0101241291",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5917922",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC",
            "identifier": "163XH",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mledoux14077@direct.ecuhealth.com",
            "affiliation": "N",
            "endpointDescription": "ECU Physicians",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "600 Moye Blvd",
            "city": "Greenville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "278344300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

Verify at the official NPI Registry.