Individual provider Active NPI

Marquilla Avila-Galeana, FNP

  • Family Nurse Practitioner
  • Saint Pauls, NC
National Provider Identifier
1285204388
Registry record updated Mar 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5014746 Issued in NC
Practice address
217 W Broad St
Saint Pauls, NC 28384-1533
Phone
(910) 241-3078
Fax
(910) 241-3412
NPI assigned
Jun 30, 2021
Last updated
Mar 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5014746 NC Primary
Family Nurse Practitioner 363LF0000X AVIL-ARZSL NC

Addresses

Primary practice location

217 W Broad St
Saint Pauls, NC 28384-1533

Mailing address

5221 Paramount Pkwy Ste 220
Morrisville, NC 27560-5490

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mavilagaleana846096@direct.UNC.nchie.net Direct

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
I20210909002105 NC Practitioner - Nurse Practitioner 1850797291 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Unc Physicians Network LLCGroup PAC ID 5496940546, 985 clinicians

Practice addresses (Care Compare)

217 W Broad St
Saint Pauls, NC 28384-1533
Phone (910) 241-3078

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5014746NCMDFamily Nurse Practitioner
AVIL-ARZSLNCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Regional Physician Services CurrentSince Aug 17, 2021 Accepting new patients
Southeastern Health Physician Services CurrentSince Aug 17, 2021 Accepting new patients
Southeastern Regional Physician Services Current Accepting new patients
Unc Physicians Network LLC CurrentSince Jun 1, 2022 Accepting new patients
Unc Physicians Network LLC Current Accepting new patients

Locations

940 Martin Luther King Jr Blvd
Chapel Hill, NC 27514
Phone (919) 942-5123

2002 N Cedar St
#B
Lumberton, NC 28358
Phone (910) 272-3048

395 W 27th St
Lumberton, NC 28358
Phone (910) 738-3434

5070 Fayetteville Rd
Lumberton, NC 28358
Phone (910) 738-9577

2000 Perimeter Park Dr
Ste 200
Morrisville, NC 27560
Phone (800) 594-8624

5221 Paramount Pkwy
Ste 220
Morrisville, NC 27560
Phone (984) 215-4110

217 W Broad St
Saint Pauls, NC 28384
Phone (910) 241-3078

Interoperability endpoints

  • Direct secure messaging: mavilagaleana846096@direct.unc.nchie.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1625011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709251200000",
    "number": "1285204388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5221 PARAMOUNT PKWY STE 220",
            "city": "MORRISVILLE",
            "state": "NC",
            "postal_code": "275605490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 W BROAD ST",
            "city": "SAINT PAULS",
            "state": "NC",
            "postal_code": "283841533",
            "telephone_number": "910-241-3078",
            "fax_number": "910-241-3412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVILA-GALEANA",
        "first_name": "MARQUILLA",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-30",
        "last_updated": "2024-03-01",
        "certification_date": "2024-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5014746",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "AVIL-ARZSL",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mavilagaleana846096@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "217 W Broad St",
            "city": "Saint Pauls",
            "state": "NC",
            "country_code": "US",
            "postal_code": "283841533",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Pauls, NC

Sources for this page

Verify at the official NPI Registry.