Vivian Maria Pantelakos

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5019382 Issued in NC

Practice address

13845 Conlan Cir
Charlotte, NC 28277-2705

Phone

(704) 544-2902

NPI assigned

Dec 21, 2023

Last updated

Apr 8, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1703116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712534400000",
    "number": "1982473781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13845 CONLAN CIR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282772705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13845 CONLAN CIR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282772705",
            "telephone_number": "704-544-2902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANTELAKOS",
        "first_name": "VIVIAN MARIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-21",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5019382",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "F08231284",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pannell Wellness Solutions PLLC
• Jodie Spicer Pannell
• Justin Pannullo
• Manisha Pant, MBBS
• Florence A Pantazes, PT
• Paola R Uceda DDS PA
• Alfred Cecil Papali, MD
• Savannah Joye Pappalardo, LCMHCA, LCASA
• Gabrielle Pappas, DNP, CRNA
• Laura Pappas

• Family Nurse Practitioner in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.