Individual provider Active NPI

Anthony Azzolini, M.D.

  • Plastic Surgery Physician
  • Wilmington, NC
National Provider Identifier
1407301310
Registry record updated Oct 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
2024-03586 Issued in NC
Practice address
1911 S 17TH St Ste 100
Wilmington, NC 28401-6663
Phone
(910) 225-4842
Fax
(910) 226-0294
NPI assigned
Aug 20, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208200000X 2024-03586 NC Primary

Addresses

Primary practice location

1911 S 17TH St Ste 100
Wilmington, NC 28401-6663

Mailing address

1911 S 17TH St Ste 100
Wilmington, NC 28401-6663
Phone (910) 225-4842

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2024-03586NCMDPlastic Surgery Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1471651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761868800000",
    "number": "1407301310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1911 S 17TH ST STE 100",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284016663",
            "telephone_number": "910-225-4842",
            "fax_number": "910-226-0294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1911 S 17TH ST STE 100",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284016663",
            "telephone_number": "910-225-4842",
            "fax_number": "910-226-0294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AZZOLINI",
        "first_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-20",
        "last_updated": "2025-10-31",
        "certification_date": "2025-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "NC",
            "license": "2024-03586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.