Individual provider Active NPI

Irmanie Hemphill, M.D.

  • Family Medicine Physician
  • Monroe, NC
National Provider Identifier
1760618243
Registry record updated Feb 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME108465 Issued in FL
Practice address
1640 Campus Park Dr Ste a
Monroe, NC 28112-5284
Phone
(704) 340-6799
NPI assigned
Jun 10, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 13485 FL
Family Medicine Physician 207Q00000X 2015-02115 NC
Family Medicine Physician 207Q00000X MD51757 SC
Family Medicine Physician 207Q00000X ME108465 FL Primary

Addresses

Primary practice location

1640 Campus Park Dr Ste a
Monroe, NC 28112-5284

Mailing address

5014 Tremont Dr
Indian Trail, NC 28079-8853
Phone (305) 310-2251

Other practice location 1

11200 SW 8th St
Ahc2 #464
Miami, FL 33199
Phone (305) 348-0669

Other identifiers 7

IdentifierTypeStateIssuer
K9529OtherFLMEDICARE GROUP NUMBER
14H8VOtherFLBCBS OF FLORIDA
1760618243OtherFLTRICARE
1457376352OtherRAHN SHAW MD PA GROUP NPI
2844337OtherFLCIGNA
592696120OtherFLRAHN SHAW MD PA TAX IDENTIFICATION
004152400MedicaidFL

Other names 1

  • Dr. Irmanie Eliacin Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200601002866 NC Practitioner - Family Practice 4284806100
I20240111004901 TX Practitioner - Family Practice 4284806100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13485FLMDGeneral Practice Dentistry
2015-02115NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optumcare Florida LLC Family Medicine Past Accepting new patients
Cloud Health Medical Group, P.a. Past Accepting new patients
Pippen Health of California, P.C., a California Professional Corporati Past Accepting new patients
Michael Karagas, M.D., P.C. D/B/a/ KMG Medical Group Family Medicine Past Accepting new patients

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": "1244592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550620800000",
    "number": "1760618243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5014 TREMONT DR",
            "city": "INDIAN TRAIL",
            "state": "NC",
            "postal_code": "280798853",
            "telephone_number": "305-310-2251",
            "fax_number": "704-628-5936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 CAMPUS PARK DR STE A",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "281125284",
            "telephone_number": "704-340-6799"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11200 SW 8th St",
            "address_2": "AHC2 #464",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "33199",
            "country_code": "US",
            "telephone_number": "305-348-0669",
            "fax_number": "305-348-1495",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEMPHILL",
        "first_name": "IRMANIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-10",
        "last_updated": "2019-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "13485",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2015-02115",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "MD51757",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME108465",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "K9529",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FLORIDA",
            "identifier": "14H8V",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "1760618243",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAHN SHAW MD PA GROUP NPI",
            "identifier": "1457376352",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2844337",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAHN SHAW MD PA TAX IDENTIFICATION",
            "identifier": "592696120",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004152400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "IRMANIE",
            "last_name": "ELIACIN",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Monroe, NC

Sources for this page

Verify at the official NPI Registry.