Individual provider Active NPI

Jean Fidele Munezero, MD

  • Student in an Organized Health Care Education/Training Program
  • Monroe, NC
National Provider Identifier
1972177830
Registry record updated Jun 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1550 Faulk St Ste 2100
Monroe, NC 28112-5087
Phone
(704) 289-2553
NPI assigned
May 16, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 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

1550 Faulk St Ste 2100
Monroe, NC 28112-5087

Mailing address

1550 Faulk St Ste 2100
Monroe, NC 28112-5087
Phone (704) 289-2553

Other practice location 1

920 Madison Ave Ste 447
Memphis, TN 38103-3438
Phone (901) 448-4795

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
I20251209001287 NC Practitioner - Obstetrics/Gynecology 8729487848 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
State University of Ny Upstate Medical University, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolinas Physicians Network IncGroup PAC ID 3375449655, 2,324 clinicians

Practice addresses (Care Compare)

1550 Faulk St
Suite 2100
Monroe, NC 28112-5087
Phone (704) 289-2553

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc CurrentSince Sep 29, 2025 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Sep 29, 2025 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients

Locations

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

1550 Faulk St
Ste 2100
Monroe, NC 28112
Phone (704) 246-2889

Interoperability endpoints

  • Direct secure messaging: jmunezero3033249@carolinashealthcaresystem.direct-ci.com

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 6

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": "1621123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1972177830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 FAULK ST STE 2100",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "281125087",
            "telephone_number": "704-289-2553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 FAULK ST STE 2100",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "281125087",
            "telephone_number": "704-289-2553"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "920 Madison Ave Ste 447",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381033438",
            "country_code": "US",
            "telephone_number": "901-448-4795",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUNEZERO",
        "first_name": "JEAN FIDELE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-16",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "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 Monroe, NC

Sources for this page

Verify at the official NPI Registry.