Edward Marvin McKeithan, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

105024 Issued in NC

Practice address

3971 Business 17 E
Bolivia, NC 28422-8675

Phone

(910) 500-6451

Fax

(910) 500-6458

NPI assigned

Jun 27, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Hospital & facility affiliations

• Well Care Home Health Home health agency, Wilmington, NC, CCN 347002
• Novant Health Brunswick Medical Center Hospital, Supply, NC, CCN 340158

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: edward.mckeithan@908083095994372.direct.elationemr.com

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.

• Wilmington Family Practice PLLC

  • Physician Assistant
  • Wilmington, NC
  • NPI 1992351910

  Family

  Medicare reassignment NPD
• Goshen Medical Center Incorporated

  • Federally Qualified Health Center (FQHC)
  • Wilmington, NC
  • NPI 1144170283
  NPD (past)
• Wilmington Family Practice

  • Family Medicine Physician
  • Wilmington, NC
  • NPI 1588205397
  NPD (past)
• Wilmington Family Practice PLLC

  • Primary Care Clinic/Center
  • Bolivia, NC
  • NPI 1194361923
  NPD (past)

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

• Brunswick Community Hospital, LLC

  • General Acute Care Hospital
  • Bolivia, NC
  • NPI 1710915756
  Care Compare affiliation
• Well Care Home Health, Inc

  • Home Health Agency
  • Wilmington, NC
  • NPI 1760470660
  Care Compare affiliation

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1821295668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3971 BUSINESS 17 E",
            "city": "BOLIVIA",
            "state": "NC",
            "postal_code": "284228675",
            "telephone_number": "910-500-6451",
            "fax_number": "910-500-6458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3971 BUSINESS 17 E",
            "city": "BOLIVIA",
            "state": "NC",
            "postal_code": "284228675",
            "telephone_number": "910-500-6451",
            "fax_number": "910-500-6458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKEITHAN",
        "first_name": "EDWARD",
        "middle_name": "MARVIN",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-27",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "105024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1992351910",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Maykish, CCC-SLP
• Tracey Nicole McCarthy, DO
• Laura Ann McDaniel O'Connell, SLP
• Jennifer Lynn McGlynn, CCC-SLP
• McKeithan Health, PA
• Lloyd Calhoun Meeks, M.D.
• Amanda Mizelle, M.S.CCC-SLP
• Beverly Anne Montalvo, FNP
• Amanda Marie Montgomery, DPT
• Shakema Morgan

• Family Nurse Practitioner in Bolivia, NC
• Providers in Bolivia, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.