Individual provider Active NPI

Amparito Ivonne Fiallo, MD

  • Family Medicine Physician
  • Wilson, NC
National Provider Identifier
1073503413
Registry record updated Oct 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2007-01690 Issued in NC
Practice address
303 Green St E
Wilson, NC 27893-4105
Phone
(252) 243-9800
Fax
(252) 243-9888
NPI assigned
Oct 26, 2005
Last updated
Oct 26, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2007-01690 NC Primary

Addresses

Primary practice location

303 Green St E
Wilson, NC 27893-4105

Mailing address

303 Green St E
Wilson, NC 27893-4105
Phone (252) 293-0013

Other identifiers 1

IdentifierTypeStateIssuer
5908271MedicaidNC

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080215000488 NC Practitioner - Family Practice 1153318977 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

303 Green St E
Wilson, NC 27893-4105
Phone (252) 243-9800

8250 S NC
Elm City, NC 27822-8079
Phone (252) 443-7744

8282 NC 58
Elm City, NC 27822-8079
Phone (252) 443-7764

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2007-01690NCMDFamily Medicine Physician

Interoperability endpoints

  • Direct secure messaging: afiallo298054@direct.ochin.org

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698278400000",
    "number": "1073503413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 GREEN ST E",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278934105",
            "telephone_number": "252-293-0013",
            "fax_number": "252-243-2576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 GREEN ST E",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278934105",
            "telephone_number": "252-243-9800",
            "fax_number": "252-243-9888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIALLO",
        "first_name": "AMPARITO",
        "middle_name": "IVONNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-26",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2007-01690",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5908271",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilson, NC

Sources for this page

Verify at the official NPI Registry.