Individual provider Active NPI

Jennifer C Nicolini, M.D.

  • Internal Medicine Physician
  • Arden, NC
National Provider Identifier
1477529725
Registry record updated Feb 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2004000722 Issued in NC
Practice address
600 Julian LN
Suite 630
Arden, NC 28704-7813
Phone
(828) 651-0121
Fax
(828) 651-0141
NPI assigned
Feb 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2004000722 NC Primary

Addresses

Primary practice location

600 Julian LN
Suite 630
Arden, NC 28704-7813

Mailing address

600 Julian Lane
Suite 630
Arden, NC 28704
Phone (828) 651-0121

Other identifiers 7

IdentifierTypeStateIssuer
01760OtherCOMMERCIAL PRIVATE PAY
P00157233OtherMEDICARE METRAHEALTH
1369EOtherBCBS
891369EOtherCAROLINA ACCESS
891369EMedicaidNC
561565803OtherCIGNA HEALTHCARE OF NC
2307353OtherUHC

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040823001454 NC Practitioner - Internal MedicinePractitioner - Pediatric Medicine 2961484001 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
Brody School of Medicine at East Carolina University, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Asheville Medicine and Pediatrics LTDGroup PAC ID 7113958349, 5 clinicians

Practice addresses (Care Compare)

600 Julian LN
Suite 630
Arden, NC 28704-7812
Phone (828) 651-0121

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2004000722NCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Asheville Medicine & Pediatrics, LTD Internal Medicine CurrentSince Feb 1, 2016 Accepting new patients
Sun Health Corporation Past Accepting new patients

Locations

600 Julian Ln
Ste 630
Arden, NC 28704
Phone (828) 651-0003

Interoperability endpoints

  • Direct secure messaging: jennifer-nicolini@ashmedpeds.e-mdsdirect.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456444800000",
    "number": "1477529725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 JULIAN LANE",
            "address_2": "SUITE 630",
            "city": "ARDEN",
            "state": "NC",
            "postal_code": "28704",
            "telephone_number": "828-651-0121",
            "fax_number": "828-651-0141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 JULIAN LN",
            "address_2": "SUITE 630",
            "city": "ARDEN",
            "state": "NC",
            "postal_code": "287047813",
            "telephone_number": "828-651-0121",
            "fax_number": "828-651-0141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICOLINI",
        "first_name": "JENNIFER",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-27",
        "last_updated": "2016-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2004000722",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL PRIVATE PAY",
            "identifier": "01760",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE METRAHEALTH",
            "identifier": "P00157233",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1369E",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAROLINA ACCESS",
            "identifier": "891369E",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891369E",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTHCARE OF NC",
            "identifier": "561565803",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "2307353",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arden, NC

Sources for this page

Verify at the official NPI Registry.