Individual provider Active NPI

Marzena E Krawiec, MD

  • Pediatric Pulmonology Physician
  • Wilmington, NC
National Provider Identifier
1477637189
Registry record updated Jul 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X
License
2012-01877 Issued in NC
Practice address
2131 S 17TH St
Coastal Childrens Services, PLLC
Wilmington, NC 28401-7407
Phone
(910) 667-9402
Fax
(877) 665-4450
NPI assigned
Oct 25, 2006
Last updated
Jul 9, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Pulmonology Physician 2080P0214X 34696 CO
Pediatric Pulmonology Physician 2080P0214X 2012-01877 NC Primary

Addresses

Primary practice location

2131 S 17TH St
Coastal Childrens Services, PLLC
Wilmington, NC 28401-7407

Mailing address

2131 S 17TH St
Coastal Childrens Services, PLLC
Wilmington, NC 28401-7407
Phone (910) 667-9402

Other identifiers 3

IdentifierTypeStateIssuer
01346964MedicaidCO
5921612MedicaidNC
174ANOtherNCBCBSNC

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
I20121106000217 NC Practitioner - Pediatric MedicinePractitioner - Pulmonary Disease 6406840339 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34696COMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group Coastal Region, LLC CurrentSince Nov 26, 2021 Accepting new patients
NMG Health Services LLC CurrentSince Nov 26, 2021 Accepting new patients
Novant Health Medical Group Coastal Region, LLC Current Accepting new patients
New Hanover Medical Group PA Past Accepting new patients

Locations

800 Jefferson St
Ste 112
Whiteville, NC 28472
Phone (910) 642-8164

2131 S 17th St
Wilmington, NC 28401
Phone (910) 342-3000

510 Carolina Bay Dr
Ste 200
Wilmington, NC 28403
Phone (910) 662-8888

Interoperability endpoints

  • Direct secure messaging: mkrawiec1248237@direct.novanthealth.org

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436400000000",
    "number": "1477637189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2131 S 17TH ST",
            "address_2": "COASTAL CHILDRENS SERVICES, PLLC",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017407",
            "telephone_number": "910-667-9402",
            "fax_number": "877-665-4450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2131 S 17TH ST",
            "address_2": "COASTAL CHILDRENS SERVICES, PLLC",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017407",
            "telephone_number": "910-667-9402",
            "fax_number": "877-665-4450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAWIEC",
        "first_name": "MARZENA",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2015-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "CO",
            "license": "34696",
            "primary": false
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "NC",
            "license": "2012-01877",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01346964",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5921612",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC",
            "identifier": "174AN",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.