Individual provider Active NPI

Minnu Ittiachen Kinattingal

  • Student in an Organized Health Care Education/Training Program
  • Lumberton, NC
National Provider Identifier
1609660380
Registry record updated Apr 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
395 W 27TH St
Lumberton, NC 28358
Phone
(910) 739-7551
NPI assigned
Apr 7, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

395 W 27TH St
Lumberton, NC 28358

Mailing address

300 W 27TH St
Lumberton, NC 28358

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
I20251114002915 NC Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 3072004225

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1743984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743984000000",
    "number": "1609660380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W 27TH ST",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "28358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395 W 27TH ST",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "28358",
            "telephone_number": "910-739-7551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ITTIACHEN KINATTINGAL",
        "first_name": "MINNU",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-07",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lumberton, NC

Sources for this page

Verify at the official NPI Registry.