John Joseph Mezzullo, DO

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

9900611 Issued in NC

Practice address

2800 Village Way
Trent Woods, NC 28562-7305

Phone

(252) 637-7300

Fax

(252) 637-1772

NPI assigned

Jun 7, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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

Specialty

Internal MedicineAlso: Psychiatry

Education

Brody School of Medicine at East Carolina University, 1999

Medicare assignment

May accept Medicare assignment

Group practices

Appalachian Regional Behavioral Healthcare IncGroup PAC ID 6002216256, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jmezzullo15822@directhisp.wakemed.org

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.

• Appalachian Regional Behavioral Healthcare Inc

  • Psychiatry Physician
  • Linville, NC
  • NPI 1629642475

  NC, Psychiatry

  Medicare reassignment Care Compare group NPD
• Charles a Cannon Jr Memorial Hospital Inc

  • Psychiatric Hospital Unit
  • Linville, NC
  • NPI 1407006968

  NC

  Medicare reassignment NPD
• Wakemed Specialists Group, LLC

  • Cardiovascular Disease Physician
  • Raleigh, NC
  • NPI 1588227839

  NC

  Medicare reassignment NPD
• Appalachian Regional Behavioral Healthcare Inc

  • Psychiatric Hospital
  • Linville, NC
  • NPI 1558975219
  Care Compare group NPD
• Charles a. Cannon, Jr. Memorial Hospital, Inc

  • Psychiatry Physician
  • Linville, NC
  • NPI 1518906700

  Psychiatry

  NPD
• Eventus WH PLLC Care, LLC

  • Family Medicine Physician
  • Charlotte, NC
  • NPI 1639990658
  NPD
• Wakemed Specialists Group LLC

  • Cardiac Rehabilitation Registered Nurse
  • Raleigh, NC
  • NPI 1063304228
  NPD
• Wakemed Specialists Group, LLC

  • Psychiatry Physician
  • Raleigh, NC
  • NPI 1194389643

  Psychiatry

  NPD
• Carolina Psychiatric and Wellness, PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Trent Woods, NC
  • NPI 1174487292

  Psychiatry

  NPD (past)
• Carolinaeast Medical Center

  • Primary Care Clinic/Center
  • Vanceboro, NC
  • NPI 1164476834
  NPD (past)
• Charles D Godwin

  • Psychiatry Physician
  • Trent Woods, NC
  • NPI 1134176506

  Psychiatry

  NPD (past)
• Raleigh Adult Medicine PA

  • Internal Medicine Physician
  • Raleigh, NC
  • NPI 1902840762
  NPD (past)

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569196800000",
    "number": "1497795553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 VILLAGE WAY",
            "city": "TRENT WOODS",
            "state": "NC",
            "postal_code": "285627305",
            "telephone_number": "252-637-7300",
            "fax_number": "252-637-1772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 VILLAGE WAY",
            "city": "TRENT WOODS",
            "state": "NC",
            "postal_code": "285627305",
            "telephone_number": "252-637-7300",
            "fax_number": "252-637-1772"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Cabarrus Ave E Ste 200",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NC",
            "postal_code": "280253781",
            "country_code": "US",
            "telephone_number": "888-849-7379",
            "fax_number": "855-857-7333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEZZULLO",
        "first_name": "JOHN",
        "middle_name": "JOSEPH",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2019-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "9900611",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NC",
            "license": "9900611",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8912325",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "12325",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Richard Allan Knazek, M.D.
• Mark W. Russell, DMD, PLLC
• Courtney Davis Mathews
• Rose V McAden, FNP
• Patrick M McDonough, DDS
• Jasmin Denise Miles, LCMHCA
• Jasmine B Murphy, BSN, RN, IBCLC
• Kimberly Lewis Oncavage, O.D.
• Patrick M. McDonough, D.D.S., M.S., P.a.
• Maria Scalf Priest, MSW, LCSW, LCAS-A

• All providers in Trent Woods, NC
• Hospitalist Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.