Individual provider Active NPI

Jennylle Zanzi, FNP-C

  • Nurse Practitioner
  • Wake Forest, NC
National Provider Identifier
1265914360
Registry record updated Sep 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ZANZ-IFYBBC Issued in NC
Practice address
301 S White St
Wake Forest, NC 27587-2916
Phone
(786) 344-2774
NPI assigned
Sep 5, 2018
Last updated
Sep 5, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F08180387 NC
Nurse Practitioner 363L00000X ZANZ-IFYBBC NC Primary

Addresses

Primary practice location

301 S White St
Wake Forest, NC 27587-2916

Mailing address

550 Callandale LN
Durham, NC 27703-9810
Phone (178) 634-4277

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20191228000301 NC Practitioner - Nurse Practitioner 2860826856 Reassigns benefits to 1 organization
I20210113002729 VA Practitioner - Nurse Practitioner 2860826856 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F08180387NCMDNurse Practitioner
ZANZ-IFYBBCNCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Wound Care Virginia PLLC CurrentSince Nov 26, 2020 Accepting new patients
Integrated Wound Care North Carolina PLLC CurrentSince Oct 8, 2019 Accepting new patients

Locations

115 N Country Club Rd
Brevard, NC 28712
Phone (828) 553-2546

492C Cedar Ln
Teaneck, NJ 07666
Phone (201) 357-5468

324 King George Ave SW
Roanoke, VA 24016
Phone (540) 309-9895

Organizations & group practices 2

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": "1536105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536105600000",
    "number": "1265914360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 CALLANDALE LN",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277039810",
            "telephone_number": "178-634-4277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 S WHITE ST",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275872916",
            "telephone_number": "786-344-2774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZANZI",
        "first_name": "JENNYLLE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-05",
        "last_updated": "2018-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "F08180387",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "ZANZ-IFYBBC",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wake Forest, NC

Sources for this page

Verify at the official NPI Registry.