Active NPI
Elizabeth Leonila Palavecino, MD
- Medical Microbiology Physician
- Winston Salem, NC
National Provider Identifier
1790769180
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Microbiology Physician
- License
- 200301032
- Practice address
- Medical Center Blvd
Winston Salem, NC 27157-0001 - Phone
- (336) 716-2255
- Fax
- (336) 716-7595
- NPI assigned
- Nov 30, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Microbiology Physician | 207ZM0300X | 200301032 | NC | Primary |
| Clinical Pathology/Laboratory Medicine Physician | 207ZP0105X | 200301032 | NC |
Addresses
Primary practice location
Medical Center Blvd
Winston Salem, NC 27157-0001
Mailing address
PO Box 344
Winston Salem, NC 27102-0344
Phone (336) 716-2255
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2005694000 | Medicaid | WV | |
| 7067670 | Other | NC | AETNA |
| 803319 | Other | NC | PARTNERS |
| 10017807 | Medicaid | VA | |
| 1341V | Other | NC | BCBS |
| C8207 | Other | NC | MEDCOST |
| 891341V | Medicaid | NC |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 200301032 | NC | MD | Clinical Pathology/Laboratory Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133308800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1282521600000",
"number": "1790769180",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 344",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271020344",
"telephone_number": "336-716-2255",
"fax_number": "336-716-7595"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "MEDICAL CENTER BLVD",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271570001",
"telephone_number": "336-716-2255",
"fax_number": "336-716-7595"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PALAVECINO",
"first_name": "ELIZABETH",
"middle_name": "LEONILA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-30",
"last_updated": "2010-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "207ZM0300X",
"taxonomy_group": "",
"desc": "Pathology, Medical Microbiology",
"state": "NC",
"license": "200301032",
"primary": true
},
{
"code": "207ZP0105X",
"taxonomy_group": "",
"desc": "Pathology, Clinical Pathology/Laboratory Medicine",
"state": "NC",
"license": "200301032",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2005694000",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7067670",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PARTNERS",
"identifier": "803319",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10017807",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "1341V",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDCOST",
"identifier": "C8207",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "891341V",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Winston Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.