Individual provider Active NPI

Renaldo O'Neal Neeley, MD

  • Infectious Disease Physician
  • Fayetteville, NC
National Provider Identifier
1962897587
Registry record updated Jun 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
202000737 Issued in NC
Practice address
1774 Metromedical Dr
Fayetteville, NC 28304-3861
Phone
(910) 568-3903
Fax
(910) 568-3908
NPI assigned
Mar 31, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 202000737 NC Primary

Addresses

Primary practice location

1774 Metromedical Dr
Fayetteville, NC 28304-3861

Mailing address

1774 Metromedical Dr
Fayetteville, NC 28304-3861
Phone (910) 568-3903

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, MD, DE3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20200708001429 NC Practitioner - Infectious DiseasePractitioner - Internal Medicine 7214273622 Reassigns benefits to 1 organization
I20231012002779 MD Practitioner - Infectious Disease 7214273622 Reassigns benefits to 1 organization
I20231012002931 DE Practitioner - Infectious Disease 7214273622 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Infectious Disease Consultants PAGroup PAC ID 4183615081, 9 clinicians

Practice addresses (Care Compare)

137 W High St
Suite 1a
Elkton, MD 21921-8614
Phone (302) 994-9692

537 Stanton Christiana Rd
Suite 201
Newark, DE 19713-2145
Phone (302) 994-9692

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
202000737NCMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cid PA Infectious Disease CurrentSince Jul 1, 2020 Accepting new patients
Infectious Disease Consultants PA Infectious Disease CurrentSince Aug 1, 2023 Accepting new patients
Fayetteville Plastic Surgery Specialists, PA PastSince Jun 28, 2020 Accepting new patients

Locations

537 Stanton Christiana Rd
Ste 201
Newark, DE 19713
Phone (302) 994-9692

137 W High St
Ste 1A
Elkton, MD 21921
Phone (410) 620-9200

106 Bow St
Elkton, MD 21921
Phone (410) 298-2000

1774 Metromedical Dr
Fayetteville, NC 28304
Phone (910) 323-1203

Interoperability endpoints

  • Direct secure messaging: rneeley2753651@direct.trinity-health.org

Organizations & group practices 3

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 3

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": "1427760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592956800000",
    "number": "1962897587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1774 METROMEDICAL DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043861",
            "telephone_number": "910-568-3903",
            "fax_number": "910-568-3908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1774 METROMEDICAL DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043861",
            "telephone_number": "910-568-3903",
            "fax_number": "910-568-3908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEELEY",
        "first_name": "RENALDO",
        "middle_name": "O'NEAL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-31",
        "last_updated": "2020-06-24",
        "certification_date": "2020-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NC",
            "license": "202000737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.