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1487649513

NPI Code Detail

MEDICARE: DR. RICKIE KELVIN MONROE MD

MEDICARE: DR. RICKIE KELVIN MONROE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	35.065479	OH
2	207L00000X	Anesthesiology Physician	MD430885	PA
3	207L00000X	Anesthesiology Physician	2022-01330	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	4238531	OTHER	OH	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	10829973	OTHER		CAQH

General Provider Information

NPI Number	:	1487649513
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICKIE KELVIN MONROE MD

Provider Business Mailing Address
First Line	:	2460 CURTIS ELLIS DR
Second Line	:
City	:	ROCKY MOUNT
State	:	NC
Zip	:	27804-2237
Country	:	US
Telephone Number	:	919-966-5136
Fax Number	:

Provider Business Practice Location Address
First Line	:	2460 CURTIS ELLIS DR
Second Line	:
City	:	ROCKY MOUNT
State	:	NC
Zip	:	27804-2237
Country	:	US
Telephone Number	:	919-966-5136
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/14/2005
Last Update Date	:	01/30/2025

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Directions to “ DR. RICKIE KELVIN MONROE MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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