Active NPI
Kristina Grace Dimiceli, MD
- Student in an Organized Health Care Education/Training Program
- Boone, NC
National Provider Identifier
1356143747
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 148 NC-105 Extension
Suite 102
Boone, NC 26807 - Phone
- (828) 262-4100
- NPI assigned
- Mar 26, 2025
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
148 NC-105 Extension
Suite 102
Boone, NC 26807
Mailing address
148 NC-105 Extension
Suite 102
Boone, NC 26807
Phone (828) 262-4100
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: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250809000034 | NC | Order and Referring Only - Family Practice | 9335647379 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1742947200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1742947200000",
"number": "1356143747",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "148 NC-105 EXTENSION",
"address_2": "SUITE 102",
"city": "BOONE",
"state": "NC",
"postal_code": "26807",
"telephone_number": "828-262-4100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "148 NC-105 EXTENSION",
"address_2": "SUITE 102",
"city": "BOONE",
"state": "NC",
"postal_code": "26807",
"telephone_number": "828-262-4100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIMICELI",
"first_name": "KRISTINA",
"middle_name": "GRACE",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-03-26",
"last_updated": "2025-03-26",
"certification_date": "2025-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boone, NC
- Harjot Singh Dhingra, D.O
- Haley Dicken
- Joseph Warren Dickson, LPC
- Amber Glasco Dillard, LCSW
- Taylor Anne-Marie Dillard
- Anne Dixon, PA-C
- DLP Central Carolina Physician Practices LLC (Mountain Family Medicine)
- DLP Central Carolina Physician Practices LLC (Harter Family Practice)
- DLP Frye Medical Group LLC (FryeCare Family Medicine Watauga)
- DLP Frye Medical Group LLC (FryeCare Family Practice Boone)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.