Active NPI
Michael Lee Mazzella, PT
- Specialist
- Cary, NC
National Provider Identifier
1306871033
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 3168
- Practice address
- 1120 S. E. Cary Pkwy
Suite 100
Cary, NC 27518 - Phone
- (919) 467-4992
- Fax
- (919) 297-0145
- NPI assigned
- Jul 11, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 3168 | NC | Primary |
Addresses
Primary practice location
1120 S. E. Cary Pkwy
Suite 100
Cary, NC 27518
Mailing address
1120 S. E. Cary Pkwy
Suite 100
Cary, NC 27518
Phone (919) 467-4992
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 07891 | Other | NC | BCBS PROVIDER NUMBER |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3168 | NC | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1306871033",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1120 S. E. CARY PKWY",
"address_2": "SUITE 100",
"city": "CARY",
"state": "NC",
"postal_code": "27518",
"telephone_number": "919-467-4992",
"fax_number": "919-297-0145"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1120 S. E. CARY PKWY",
"address_2": "SUITE 100",
"city": "CARY",
"state": "NC",
"postal_code": "27518",
"telephone_number": "919-467-4992",
"fax_number": "919-297-0145"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAZZELLA",
"first_name": "MICHAEL",
"middle_name": "LEE",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NC",
"license": "3168",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER NUMBER",
"identifier": "07891",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cary, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.