Individual provider Active NPI

Lindsey Elizabeth Sirianno, PA-C

  • Physician Assistant
  • Charlotte, NC
National Provider Identifier
1255643573
Registry record updated Dec 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-04596 Issued in NC
Practice address
1021 Morehead Medical Dr
Suite a
Charlotte, NC 28204-2839
Phone
(980) 442-2000
Fax
(704) 355-5800
NPI assigned
Jul 2, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-04596 NC Primary
Medical Physician Assistant 363AM0700X 005844 GA
Medical Physician Assistant 363AM0700X 0010-04596 NC

Addresses

Primary practice location

1021 Morehead Medical Dr
Suite a
Charlotte, NC 28204-2839

Mailing address

PO Box 602120
Charlotte, NC 28260-2120
Phone (980) 442-2000

Other identifiers 2

IdentifierTypeStateIssuer
1255643573MedicaidNC
1833PAMedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-04596NCMDPhysician Assistant
005844GAMDMedical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1278028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483056000000",
    "number": "1255643573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 602120",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282602120",
            "telephone_number": "980-442-2000",
            "fax_number": "704-355-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 MOREHEAD MEDICAL DR",
            "address_2": "SUITE A",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282042839",
            "telephone_number": "980-442-2000",
            "fax_number": "704-355-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIRIANNO",
        "first_name": "LINDSEY",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-02",
        "last_updated": "2016-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-04596",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "005844",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-04596",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1255643573",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1833PA",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.