Active NPI
Michele Clancy, MD
- Internal Medicine Physician
- Wilmington, NC
National Provider Identifier
1811086390
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 32351
- Practice address
- 1406 Physicians Dr
Wilmington, NC 28401-7335 - Phone
- (910) 762-9422
- Fax
- (910) 341-3014
- NPI assigned
- Oct 12, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 32351 | NC | Primary |
Addresses
Primary practice location
1406 Physicians Dr
Wilmington, NC 28401-7335
Mailing address
1414 Physicians Drive
Wilmington, NC 28401-7335
Phone (910) 796-7900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8911324 | 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 |
|---|---|---|---|
| 32351 | NC | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1236124800000",
"number": "1811086390",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1414 PHYSICIANS DRIVE",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284017335",
"telephone_number": "910-796-7900",
"fax_number": "910-796-7901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1406 PHYSICIANS DR",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284017335",
"telephone_number": "910-762-9422",
"fax_number": "910-341-3014"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLANCY",
"first_name": "MICHELE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-12",
"last_updated": "2009-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NC",
"license": "32351",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8911324",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wilmington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.