NPIMap

Organization Active NPI

New Hanover Medical Group PA

  • Family Medicine Physician
  • Wilmington, NC
National Provider Identifier
1992751374
Registry record updated Nov 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
41057 Issued in NC
Legal business name
NEW HANOVER MEDICAL GROUP PA
Practice address
1960 S 16TH St
Wilmington, NC 28401-6647
Phone
(910) 343-9991
NPI assigned
May 26, 2006
Last updated
Nov 11, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2009

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

Authorized official

Name
Ms. Margo J Illobre
Title
Business Office Supervisor
Phone
(910) 343-9991

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 41057 NC Primary
Internal Medicine Physician 207R00000X 41057 NC
Body Imaging Physician 2085B0100X NU

Addresses

Primary practice location

1960 S 16TH St
Wilmington, NC 28401-6647

Mailing address

1960 S 16TH St
Wilmington, NC 28401-6647
Phone (910) 343-9991

Other identifiers 1

IdentifierTypeStateIssuer
890218JMedicaidNC

National Provider Directory

National Provider Directory

Locations

1960 S 16th St
Ste A
Wilmington, NC 28401

Practitioners & affiliated clinicians

Practitioners 404

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 404

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257897600000",
    "number": "1992751374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1960 S 16TH ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284016647",
            "telephone_number": "910-343-9991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1960 S 16TH ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284016647",
            "telephone_number": "910-343-9991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW HANOVER MEDICAL GROUP PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2009-11-11",
        "status": "A",
        "authorized_official_last_name": "ILLOBRE",
        "authorized_official_first_name": "MARGO",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "BUSINESS OFFICE SUPERVISOR",
        "authorized_official_telephone_number": "910-343-9991",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "41057",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "41057",
            "primary": false
        },
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890218J",
            "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 Nov 11, 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.

Verify at the official NPI Registry.