Active NPI
Diane A. Lippiello, PT
- Physical Therapist
- Winston Salem, NC
National Provider Identifier
1326169129
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1469
- Practice address
- 4505 Shattalon Dr
Winston Salem, NC 27106-2001 - Phone
- (336) 924-9309
- Fax
- (336) 924-0388
- NPI assigned
- Apr 2, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1469 | NC | Primary |
Addresses
Primary practice location
4505 Shattalon Dr
Winston Salem, NC 27106-2001
Mailing address
4505 Shattalon Dr
Winston Salem, NC 27106-2001
Phone (336) 924-9309
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7211773 | Medicaid | NC |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1469 | 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": "1175472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1326169129",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4505 SHATTALON DR",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271062001",
"telephone_number": "336-924-9309",
"fax_number": "336-924-0388"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4505 SHATTALON DR",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271062001",
"telephone_number": "336-924-9309",
"fax_number": "336-924-0388"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIPPIELLO",
"first_name": "DIANE",
"middle_name": "A.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "1469",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7211773",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Winston Salem, 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.