Active NPI
Frank Joseph Colella, FNP-BC
- Nurse Practitioner
- Kernersville, NC
National Provider Identifier
1417016759
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 5015447
- Practice address
- 794 S Main St Ste B
Kernersville, NC 27284-4074 - Phone
- (336) 904-2317
- Fax
- (336) 443-6030
- NPI assigned
- Dec 6, 2006
- Last updated
- Apr 7, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 5015447 | NC | Primary |
| Family Nurse Practitioner | 363LF0000X | TAP2564 | AZ |
Addresses
Primary practice location
794 S Main St Ste B
Kernersville, NC 27284-4074
Mailing address
PO Box 601843
Charlotte, NC 28260-1843
Other practice location 1
3769 Crossing drive
Suite B
Prescott, AZ 86305-3700
Phone (928) 458-7343
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AP2564 | Other | AZ | AP LIC |
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
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TAP2564 | AZ | MD | Family Nurse Practitioner |
Interoperability endpoints
- fcolella1035099@direct.novanthealth.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649289600000",
"number": "1417016759",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 601843",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282601843"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "794 S MAIN ST STE B",
"city": "KERNERSVILLE",
"state": "NC",
"postal_code": "272844074",
"telephone_number": "336-904-2317",
"fax_number": "336-443-6030"
}
],
"practiceLocations": [
{
"address_1": "3769 Crossing drive",
"address_2": "Suite B",
"address_purpose": "LOCATION",
"city": "Prescott",
"state": "AZ",
"postal_code": "863053700",
"country_code": "US",
"telephone_number": "928-458-7343",
"fax_number": "888-491-4424",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "COLELLA",
"first_name": "FRANK",
"middle_name": "JOSEPH",
"name_prefix": "Mr.",
"credential": "FNP-BC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-06",
"last_updated": "2022-04-07",
"certification_date": "2022-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NC",
"license": "5015447",
"primary": true
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "AZ",
"license": "TAP2564",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AP LIC",
"identifier": "AP2564",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kernersville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.