Individual provider Active NPI

Nicole Jennifer Yonnetti, FNP

  • Family Nurse Practitioner
  • Raleigh, NC
National Provider Identifier
1841026150
Registry record updated Nov 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5021078 Issued in NC
Practice address
11801 Stannary PL
Raleigh, NC 27613-7816
Phone
(919) 274-5333
NPI assigned
Sep 12, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 159628 NC
Family Nurse Practitioner 363LF0000X 5021078 NC Primary

Addresses

Primary practice location

11801 Stannary PL
Raleigh, NC 27613-7816

Mailing address

11801 Stannary PL
Raleigh, NC 27613-7816
Phone (919) 274-5333

Other practice location 1

2334 41st St
Wilmington, NC 28403-5502
Phone (910) 918-1097

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250109000165 NC Practitioner - Nurse Practitioner 1658809371 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
159628NCMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Liberty Medical Care Services, LLC CurrentSince Oct 24, 2024 Accepting new patients

Locations

3000 Holston Ln
Raleigh, NC 27610
Phone (919) 231-6045

44 McNeill Plz
Whiteville, NC 28472
Phone (910) 642-0224

Interoperability endpoints

  • Direct secure messaging: nyonnetti552218@directhisp.wakemed.org

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1726099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731024000000",
    "number": "1841026150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11801 STANNARY PL",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276137816",
            "telephone_number": "919-274-5333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11801 STANNARY PL",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276137816",
            "telephone_number": "919-274-5333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2334 41st St",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284035502",
            "country_code": "US",
            "telephone_number": "910-918-1097",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YONNETTI",
        "first_name": "NICOLE",
        "middle_name": "JENNIFER",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-12",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "159628",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5021078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.