Individual provider Active NPI

Genna Ciccarelli, RN

  • Registered Nurse
  • Mint Hill, NC
National Provider Identifier
1497594279
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
320691 Issued in NC
Practice address
5309 Idlewild Rd N
Mint Hill, NC 28227-3962
Phone
(704) 573-9777
NPI assigned
May 22, 2024
Last updated
May 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 320691 NC Primary

Addresses

Primary practice location

5309 Idlewild Rd N
Mint Hill, NC 28227-3962

Mailing address

1626 Rowemont Dr
Durham, NC 27705-6914
Phone (484) 425-7909

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
320691NCMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1716336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1497594279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1626 ROWEMONT DR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277056914",
            "telephone_number": "484-425-7909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5309 IDLEWILD RD N",
            "city": "MINT HILL",
            "state": "NC",
            "postal_code": "282273962",
            "telephone_number": "704-573-9777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CICCARELLI",
        "first_name": "GENNA",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-22",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "320691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mint Hill, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.