Individual provider Active NPI

Michele Mariano Lizano, FNP-C

  • Nurse Practitioner
  • King, NC
National Provider Identifier
1033518311
Registry record updated Aug 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5007101 Issued in NC
Practice address
167 Moore Rd Ste 206
King, NC 27021-8770
Phone
(336) 673-6450
Fax
(336) 673-6449
NPI assigned
Aug 22, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5007101 NC
Nurse Practitioner 363L00000X 5007101 NC Primary

Addresses

Primary practice location

167 Moore Rd Ste 206
King, NC 27021-8770

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other practice location 1

7811 N Point Blvd
Winston Salem, NC 27106-3209
Phone (336) 281-5965

Other practice location 2

7811 N Point Blvd
Winston Salem, NC 27106-3209
Phone (336) 281-5965

Other practice location 3

167 Moore Rd Ste 201
King, NC 27021
Phone (336) 673-6450

Other identifiers 1

IdentifierTypeStateIssuer
5007101OtherNCNORTH CAROLINA BOARD OF NURSING

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mlizano193593@direct.novanthealth.org

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150102001665 NC Practitioner - Nurse Practitioner 3779806419 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DRX High Point PLLCGroup PAC ID 7113061730, 48 clinicians
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

1653 New Garden Rd
Suite 103
Greensboro, NC 27410-2001
Phone (336) 609-6000

200 Hawthorne LN
Charlotte, NC 28204-2515
Phone (704) 384-5416

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC CurrentSince Jun 24, 2019 Accepting new patients
Forsyth Memorial Hospital, Inc. Current Accepting new patients
Carolina Medicorp Enterprises, LLC CurrentSince Oct 6, 2014 Accepting new patients
Carolina Medicorp Enterprises, LLC CurrentSince Oct 6, 2014 Accepting new patients
Forsyth Memorial Hospital Inc CurrentSince Jan 26, 2019 Accepting new patients
Express Care of Yadkin LLC Family CurrentSince Jan 1, 2016 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Jun 24, 2019 Accepting new patients
Forsyth Memorial Hospital, Inc. CurrentSince Jan 26, 2019 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
DRX High Point, PLLC CurrentSince Nov 19, 2023 Accepting new patients
American Family Care Raleigh Midtown PLLC PastSince Jan 3, 2021 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients
Carolina Medicorp Enterprises Inc Past Accepting new patients
American Family Care Fuquay PLLC Past Accepting new patients

Locations (25 of 45)

674 Merrimon Ave
Ste 101
Asheville, NC 28804
Phone (828) 348-7418

349 New Leicester Hwy
Asheville, NC 28806
Phone (828) 412-0327

201 NC Highway 9
Black Mountain, NC 28711
Phone (828) 412-0327

13129 S Tryon St
Ste 120
Charlotte, NC 28278
Phone (980) 337-4662

15235 John J Delaney Dr
Ste B
Charlotte, NC 28277
Phone (704) 243-8937

8036 Providence Rd
Ste 100
Charlotte, NC 28277
Phone (980) 301-8711

9550 Rocky River Rd
Ste 150
Charlotte, NC 28215
Phone (704) 457-1510

445 S Kings Dr
Charlotte, NC 28204
Phone (704) 384-1734

10810 Mallard Creek Rd
Charlotte, NC 28262
Phone (704) 510-8000

3836 Corning Pl
Charlotte, NC 28216
Phone (704) 317-2108

11840 Southmore Dr
Ste 100
Charlotte, NC 28277
Phone (704) 316-4440

114 S Sharon Amity Rd
Charlotte, NC 28211
Phone (980) 337-4428

8450 Park Rd
Charlotte, NC 28210
Phone (980) 308-0143

4815 Berewick Town Center Dr
Ste Cd
Charlotte, NC 28278
Phone (980) 337-4652

200 Hawthorne Ln
Charlotte, NC 28204
Phone (704) 377-2424

6301 Stadium Dr
Clemmons, NC 27012
Phone (336) 766-6473

5303 Poplar Tent Rd
Ste 90
Concord, NC 28027
Phone (980) 866-4493

6400 Fayetteville Rd
Durham, NC 27713
Phone (919) 551-2000

2635 Lawndale Dr
Greensboro, NC 27408
Phone (336) 867-4310

1653 New Garden Rd
Ste 103
Greensboro, NC 27410
Phone (336) 609-6000

5870 Samet Dr
High Point, NC 27265
Phone (336) 803-7311

2305 N Main St
High Point, NC 27262
Phone (336) 884-4050

1231 Eastchester Dr
High Point, NC 27265
Phone (336) 884-4050

9121 Sam Furr Rd
Ste 108
Huntersville, NC 28078
Phone (704) 324-3590

794 S Main St
Ste B
Kernersville, NC 27284
Phone (336) 904-2317

Interoperability endpoints

  • Direct secure messaging: mlizano193593@direct.novanthealth.org

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 1

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": "1408665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661299200000",
    "number": "1033518311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "167 MOORE RD STE 206",
            "city": "KING",
            "state": "NC",
            "postal_code": "270218770",
            "telephone_number": "336-673-6450",
            "fax_number": "336-673-6449"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7811 N Point Blvd",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271063209",
            "country_code": "US",
            "telephone_number": "336-281-5965",
            "fax_number": "336-281-5873",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7811 N Point Blvd",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271063209",
            "country_code": "US",
            "telephone_number": "336-281-5965",
            "fax_number": "336-281-5873",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "167 Moore Rd Ste 201",
            "address_purpose": "LOCATION",
            "city": "King",
            "state": "NC",
            "postal_code": "27021",
            "country_code": "US",
            "telephone_number": "336-673-6450",
            "fax_number": "336-673-6449",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIZANO",
        "first_name": "MICHELE",
        "middle_name": "MARIANO",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-22",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5007101",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5007101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH CAROLINA BOARD OF NURSING",
            "identifier": "5007101",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mlizano193593@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "7811 N Point Blvd",
            "city": "Winston Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "271063209",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in King, NC

Sources for this page

Verify at the official NPI Registry.