Individual provider Active NPI

Anthony Elkins, D.O.

  • Family Medicine Physician
  • Mooresville, NC
National Provider Identifier
1669445847
Registry record updated Mar 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
200200517 Issued in NC
Practice address
114 Gateway Blvd Ste B
Mooresville, NC 28117-5598
Phone
(980) 435-0406
Fax
(980) 435-0409
NPI assigned
Feb 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2022

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 200200517 NC Primary

Addresses

Primary practice location

114 Gateway Blvd Ste B
Mooresville, NC 28117-5598

Mailing address

PO Box 896199
Charlotte, NC 28289-0447
Phone (833) 936-1364

Other practice location 1

8420 University Exec Park Dr Ste 850
Charlotte, NC 28262-1308
Phone (704) 384-1225

Other practice location 2

8420 University Exec Park Dr
Suite 850
Charlotte, NC 28262-3381
Phone (704) 316-1750

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
I20040205000753 NC Practitioner - Family PracticePractitioner - Osteopathic Manipulative Medicine 7416840152 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iredell Physician Network LLCGroup PAC ID 0749345007, 91 clinicians

Practice addresses (Care Compare)

114 Gateway Blvd
Suite B
Mooresville, NC 28117-5598
Phone (980) 435-0406

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200200517NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Iredell Physician Network LLC CurrentSince Apr 1, 2022 Accepting new patients
Iredell Physician Network LLC CurrentSince Apr 1, 2022 Accepting new patients

Locations

114 Gateway Blvd
Ste B
Mooresville, NC 28117
Phone (704) 658-0720

766 Hartness Rd
Statesville, NC 28677
Phone (704) 838-2182

Interoperability endpoints

  • Direct secure messaging: anthony.elkins@iredell.cernerdirect.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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647475200000",
    "number": "1669445847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 896199",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282890447",
            "telephone_number": "833-936-1364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 GATEWAY BLVD STE B",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281175598",
            "telephone_number": "980-435-0406",
            "fax_number": "980-435-0409"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8420 University Exec Park Dr Ste 850",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282621308",
            "country_code": "US",
            "telephone_number": "704-384-1225",
            "fax_number": "704-384-1226",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8420 University Exec Park Dr",
            "address_2": "Suite 850",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282623381",
            "country_code": "US",
            "telephone_number": "704-316-1750",
            "fax_number": "704-316-1755",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELKINS",
        "first_name": "ANTHONY",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-09",
        "last_updated": "2022-03-17",
        "certification_date": "2022-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "200200517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mooresville, NC

Sources for this page

Verify at the official NPI Registry.