Individual provider Active NPI

Kenzie R Daniels-Fasano, M.D.

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Chapel Hill, NC
National Provider Identifier
1699206938
Registry record updated Dec 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X
License
2022-02068 Issued in NC
Practice address
100 Eastowne Dr
Chapel Hill, NC 27514-2286
Phone
(984) 974-4462
NPI assigned
Mar 27, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X 2022-02068 NC Primary
Internal Medicine Physician 207R00000X 326371 LA
Internal Medicine Physician 207R00000X 57.029648 OH
Pediatrics Physician 208000000X 57.029648 OH

Addresses

Primary practice location

100 Eastowne Dr
Chapel Hill, NC 27514-2286

Mailing address

5034 Old Clinic Building CLB #7110
Chapel Hill, NC 27599-0001

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kdaniels215616@direct.UNC.nchie.net Direct

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
I20221029000126 NC Practitioner - Internal Medicine 7416228028 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Texas Tech University Health Science Center School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of North Carolina at Chapel HillGroup PAC ID 0648181156, 2,028 clinicians

Practice addresses (Care Compare)

101 Manning Dr
Chapel Hill, NC 27514-4220
Phone (984) 974-1000

Hospital & facility affiliations

  • Unc Hospice Hospice, Chapel Hill, NC, CCN 341531
  • Unc Hospitals Hospital, Chapel Hill, NC, CCN 340061

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57.029648OHMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of North Carolina at Chapel Hill CurrentSince Sep 6, 2022 Accepting new patients
University of North Carolina at Chapel Hill Internal Medicine CurrentSince Sep 6, 2022 Accepting new patients
Park Ophthalmology Past Accepting new patients

Locations

100 Eastowne Dr
Fl 56
Chapel Hill, NC 27514
Phone (984) 215-5556

100 Eastowne Dr
Fl 14
Chapel Hill, NC 27514
Phone (984) 215-5556

101 Manning Dr
Chapel Hill, NC 27514
Phone (984) 974-1485

100 Eastowne Dr
Chapel Hill, NC 27514
Phone (984) 974-4462

Interoperability endpoints

  • Direct secure messaging: kdaniels215616@direct.unc.nchie.net

Organizations & group practices 3

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 2

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": "1490572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1699206938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5034 OLD CLINIC BUILDING CLB #7110",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275990001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 EASTOWNE DR",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275142286",
            "telephone_number": "984-974-4462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIELS-FASANO",
        "first_name": "KENZIE",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-27",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "NC",
            "license": "2022-02068",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "326371",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "57.029648",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "57.029648",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kdaniels215616@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "101 Manning Dr",
            "city": "Chapel Hill",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275144220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chapel Hill, NC

Sources for this page

Verify at the official NPI Registry.