Individual provider Active NPI

Janis Panzenhagen Puglisi, PHD, APRN, FNP-BC

  • Nurse Practitioner
  • High Point, NC
National Provider Identifier
1114017498
Registry record updated Sep 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
201506 Issued in NC
Practice address
2850 S Main St Ste 104
High Point, NC 27263-1900
Phone
(336) 200-7003
NPI assigned
Oct 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 201506NP NC
Primary Care Nurse Practitioner 363LP2300X 141960RN NC
Nurse Practitioner 363L00000X 201506 NC Primary
Family Nurse Practitioner 363LF0000X 201506 NC

Addresses

Primary practice location

2850 S Main St Ste 104
High Point, NC 27263-1900

Mailing address

PO Box 746724
Atlanta, GA 30374-6724
Phone (773) 644-3941

Other practice location 1

1941 New Garden Rd Ste 216
Greensboro, NC 27410-2555
Phone (336) 288-8857

Other identifiers 2

IdentifierTypeStateIssuer
141960OtherNCRN
201506OtherNCNURSE PRACTITIONER

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
I20041118000215 NC Practitioner - Nurse Practitioner 9931163037 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osh Mi Physicians Group, PCGroup PAC ID 7810282191, 154 clinicians

Practice addresses (Care Compare)

2850 S Main St
Suite 104
High Point, NC 27263-1900
Phone (336) 200-7003

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
201506NCMDFamily Nurse Practitioner
141960RNNCMDPrimary Care Nurse Practitioner
201506NPNCMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Osh-Mi Physicians Group PC Family CurrentSince Sep 23, 2024 Accepting new patients
General Medical Clinic, PA Family CurrentSince Jun 2, 2014 Accepting new patients
Osh Mi Physicians Group, PC CurrentSince Sep 23, 2024 Accepting new patients
Hickory Allergy and Asthma Clinic, PA PastSince Jul 15, 1998 Accepting new patients
R E Williford MD PA PastSince Sep 21, 2013 Accepting new patients

Locations

230 Foust St
Asheboro, NC 27203
Phone (336) 633-0407

3250 Freedom Dr
Charlotte, NC 28208
Phone (704) 394-0118

2850 S Main St
Ste 104
High Point, NC 27263
Phone (336) 200-7003

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1160870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1114017498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746724",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746724",
            "telephone_number": "773-644-3941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 S MAIN ST STE 104",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272631900",
            "telephone_number": "336-200-7003"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1941 New Garden Rd Ste 216",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274102555",
            "country_code": "US",
            "telephone_number": "336-288-8857",
            "fax_number": "336-288-8769",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PUGLISI",
        "first_name": "JANIS",
        "middle_name": "PANZENHAGEN",
        "credential": "PHD, APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-15",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NC",
            "license": "201506NP",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NC",
            "license": "141960RN",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "201506",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "201506",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN",
            "identifier": "141960",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER",
            "identifier": "201506",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in High Point, NC

Sources for this page

Verify at the official NPI Registry.