Individual provider Active NPI

Kelley Elizabeth Haven, M.D.

  • Obstetrics & Gynecology Physician
  • Greenville, NC
National Provider Identifier
1851739221
Registry record updated Dec 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
2017-01465 Issued in NC
Practice address
2160 Herbert CT
Greenville, NC 27834-3736
Phone
(252) 744-3850
Fax
(252) 744-3894
NPI assigned
Jun 7, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2017-01465 NC
Obstetrics & Gynecology Physician 207V00000X 2017-01465 NC Primary

Addresses

Primary practice location

2160 Herbert CT
Greenville, NC 27834-3736

Mailing address

PO Box 751069
Charlotte, NC 28275-1069

Other identifiers 3

IdentifierTypeStateIssuer
1851739221MedicaidNC
19R2POtherNCBCBS OF NC
NCZ066AOtherNCMEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address khaven49260@direct.ecuhealth.com

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
I20171004003261 NC Practitioner - Obstetrics/GynecologyPractitioner - Family Practice 6709175086 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Carolina UniversityGroup PAC ID 0244143246, 499 clinicians

Practice addresses (Care Compare)

2100 Stantonsburg Rd
Greenville, NC 27834-2818
Phone (252) 209-3000

2150 Herbert CT
Greenville, NC 27834-3736
Phone (252) 744-5437

2160 Herbert CT
Greenville, NC 27834-3736
Phone (252) 744-3850

600 Moye Blvd
Greenville, NC 27834-4300
Phone (252) 744-4611

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2017-01465NCMDObstetrics & Gynecology Physician
N/ANCMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
East Carolina University Obstetrics & Gynecology Past Accepting new patients

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 2

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": "1370563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701388800000",
    "number": "1851739221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751069",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 HERBERT CT",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278343736",
            "telephone_number": "252-744-3850",
            "fax_number": "252-744-3894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVEN",
        "first_name": "KELLEY",
        "middle_name": "ELIZABETH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-07",
        "last_updated": "2023-12-01",
        "certification_date": "2023-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2017-01465",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NC",
            "license": "2017-01465",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1851739221",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "19R2P",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "NCZ066A",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "khaven49260@direct.ecuhealth.com",
            "affiliation": "N",
            "endpointDescription": "ECU Physicians",
            "address_1": "2160 Herbert Ct",
            "city": "Greenville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "278343736",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

Verify at the official NPI Registry.