Individual provider Active NPI

Michael Anthony Covelli, M.D.

  • Surgical Oncology Physician
  • Low Moor, VA
National Provider Identifier
1669436044
Registry record updated Nov 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Oncology PhysicianTaxonomy code 2086X0206X
License
0101260875 Issued in VA
Practice address
200 Arh LN 102
Low Moor, VA 24457
Phone
(540) 862-6777
Fax
(540) 863-9167
NPI assigned
Apr 13, 2006
Last updated
Nov 8, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Oncology Physician 2086X0206X 17901 WV
Surgical Oncology Physician 2086X0206X 0101260875 VA Primary

Addresses

Primary practice location

200 Arh LN 102
Low Moor, VA 24457

Mailing address

200 Arh LN 102
Low Moor, VA 24457
Phone (540) 862-6777

Other identifiers 1

IdentifierTypeStateIssuer
P00247564OtherRAILROAD MEDICARE

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
17901WVMDSurgical Oncology Physician

NPI Registry JSON

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

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478563200000",
    "number": "1669436044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 ARH LN 102",
            "city": "LOW MOOR",
            "state": "VA",
            "postal_code": "24457",
            "telephone_number": "540-862-6777",
            "fax_number": "540-863-9167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 ARH LN 102",
            "city": "LOW MOOR",
            "state": "VA",
            "postal_code": "24457",
            "telephone_number": "540-862-6777",
            "fax_number": "540-863-9167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COVELLI",
        "first_name": "MICHAEL",
        "middle_name": "ANTHONY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-13",
        "last_updated": "2016-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "WV",
            "license": "17901",
            "primary": false
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "VA",
            "license": "0101260875",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00247564",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Low Moor, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2016; 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.