Michael Alan Bellamy, M.D.
Individual provider Active NPI Pediatrics Physician · Lexington, NC
NPI 1932246774 · NPPES record last updated Feb 9, 2012
Key facts
- NPI
- 1932246774
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 159936 (NY)
- Practice address
- 8 Medical Park Dr
Lexington, NC 27292-6768 - Phone
- (336) 243-4911
- Fax
- (336) 249-1782
- NPI assigned
- Jan 31, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20111216000745 | NC | Practitioner - Pediatric Medicine | 4385819580 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 159936 | NY | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bladen Healthcare LLC | Current |
Accepting new patients | |
| Bladen Healthcare LLC | Current |
Accepting new patients | |
| Wake Forest University Health Sciences | Current |
Accepting new patients | |
| Bladen Healthcare LLC | Current | Accepting new patients | |
| Wake Forest University Health Sciences | Current |
Accepting new patients |
Locations
501 S Poplar St
Elizabethtown, NC 28337
Phone (910) 862-4043
300 E McKay St
#F
Elizabethtown, NC 28337
Phone (910) 862-6672
300A E McKay St
Elizabethtown, NC 28337
Phone (910) 862-5500
8 Medical Park Dr
Lexington, NC 27292
Phone (336) 249-4911
Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697
Interoperability endpoints
- mbellamy10223@capefearvalley.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 159936 | NY | Yes |
Addresses
Primary practice location
8 Medical Park Dr
Lexington, NC 27292-6768
Mailing address
8 Medical Park Drive
Wfuhs - Lexmedical Pediatrics
Lexington, NC 27292-6768
Phone (336) 243-4656
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5911065 | Medicaid | NC |
Other providers in Lexington, NC
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- Benchmark Communication Services, Inc
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All providers in Lexington, NC · Pediatrics Physician in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 9, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.