Individual provider Active NPI

Nicholas Ryan Fiacco

  • Internal Medicine Physician
  • Chapel Hill, NC
National Provider Identifier
1093042095
Registry record updated Dec 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
201801251 Issued in NC
Practice address
112 Perkins Dr Ste 400
Chapel Hill, NC 27514-1786
Phone
(984) 261-1560
NPI assigned
Nov 11, 2009
Last updated
Dec 5, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101256953 VA
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 201801251 NC
Internal Medicine Physician 207R00000X 201801251 NC Primary

Addresses

Primary practice location

112 Perkins Dr Ste 400
Chapel Hill, NC 27514-1786

Mailing address

112 Perkins Dr Ste 400
Chapel Hill, NC 27514-1786
Phone (984) 261-1560

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
I20220512001767 NC Practitioner - EndocrinologyPractitioner - Internal Medicine 1557687654 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
Mercer University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Forsyth Medical Group, LLCGroup PAC ID 3678478054, 47 clinicians

Practice addresses (Care Compare)

27 Doctors Dr
Hendersonville, NC 28792-7209
Phone (828) 687-3800

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101256953VAMDInternal Medicine Physician
201801251NCMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jacksonville Children's and Multispecialty Clinic, PA Internal Medicine CurrentSince Jul 1, 2022 Accepting new patients
Element Endocrinology and Diabetes, PLLC Internal Medicine CurrentSince Apr 1, 2023 Accepting new patients
Forsyth Medical Group LLC CurrentSince Dec 10, 2024 Accepting new patients
Forsyth Medical Group, LLC Internal Medicine CurrentSince Dec 10, 2024 Accepting new patients
Forsyth Memorial Hospital Inc Past Accepting new patients
Family Care Clinic, P.a. PastSince May 1, 2022 Accepting new patients

Locations

530 New Waverly Pl
Ste 101
Cary, NC 27518
Phone (919) 233-3959

112 Perkins Dr
Ste 400
Chapel Hill, NC 27514
Phone (919) 960-2720

5107 Southpark Dr
Ste 202
Durham, NC 27713
Phone (919) 544-2583

812 W Haggard Ave
Elon College, NC 27244
Phone (336) 449-4030

27 Doctors Dr
Hendersonvlle, NC 28792
Phone (828) 687-3800

114C Memorial Dr
Jacksonville, NC 28546
Phone (910) 346-3976

120 Memorial Dr
Jacksonville, NC 28546
Phone (910) 353-0581

1520 Sunday Dr
Ste 309
Raleigh, NC 27607
Phone (919) 354-7077

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: nicholas.fiacco.1@27575.direct.athenahealth.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1257897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1093042095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 PERKINS DR STE 400",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275141786",
            "telephone_number": "984-261-1560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 PERKINS DR STE 400",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275141786",
            "telephone_number": "984-261-1560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIACCO",
        "first_name": "NICHOLAS",
        "middle_name": "RYAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-11-11",
        "last_updated": "2023-12-05",
        "certification_date": "2023-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101256953",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NC",
            "license": "201801251",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "201801251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chapel Hill, NC

Sources for this page

Verify at the official NPI Registry.