MARK MICELI (NPI# 1881678118) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881678118 |
| Entity Type | Individual |
| Full Name | MARK MICELI |
| Credential | DPM |
| Practice Address |
8301 University Exec Park Dr Ste 112 Charlotte NC 28262-3355 |
| Practice Telephone | 7045470000 |
| Practice Fax Number | 7045470460 |
| Mailing Telephone | 7045470000 |
| Mailing Fax Number | 7045470460 |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | 302 | NC | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BCBS | 0807M | 01 | |
| AETNA | 0004118131 | 01 | |
| NC | 890183P | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184658858 | Mark D Miceli | Psychiatry & Neurology | 4050 Coon Rapids Blvd Nw, Coon Rapids, MN 55433-2522 | 2006-07-10 |
| Street Address |
8301 UNIVERSITY EXEC PARK DR STE 112 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28262-3355 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073043642 | Medical Care of The Carolinas, Pllc | Internal Medicine | 8301 University Exec Park Dr, Charlotte, NC 28262-1366 | 2017-06-15 |
| 1649613019 | Brichelya Healthcare | In Home Supportive Care | 8301 University Exec Park Dr, Charlotte, NC 28262-1366 | 2013-04-16 |
| 1689931479 | Bcy Healthcare | Home Health | 8301 University Exec Park Dr, Suite 124, Charlotte, NC 28262-1366 | 2012-04-18 |
| 1356617385 | Britnee Richardson | Community Health Worker | 8301 University Exec Park Dr, Charlotte, NC 28262-1366 | 2012-03-23 |
| 1770859712 | Brichelya Healthcare, Inc. | In Home Supportive Care | 8301 University Exec Park Dr, Suite 124, Charlotte, NC 28262-1366 | 2012-03-23 |
| 1811040397 | Atlantic Coast Home Care | Home Health | 8301 University Exec Park Dr, Suite 170, Charlotte, NC 28262-3593 | 2007-01-19 |
| 1407893225 | Cooley Enterprises, Inc. | Home Health | 8301 University Exec Park Dr, Suite 102, Charlotte, NC 28262-3355 | 2006-06-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366056913 | Aleta Michelle Johnson | Specialist | 9711 David Taylor Dr., Ste. 145, Charlotte, NC 28262 | 2020-09-01 |
| 1275161580 | Londyn Homecare Agency L.l.c | Home Health | 1914j.n. Place, Charlotte, NC 28262 | 2020-03-31 |
| 1154964914 | Abundant Love Home Care Service LLC | In Home Supportive Care | 1981 J.n. Pease Place, Ste 204, Charlotte, NC 28262 | 2019-10-24 |
| 1104399070 | Nattya S Pilgreen | Prosthetist | 410 E Mccullough Drive, Suite 103, Charlotte, NC 28262 | 2019-01-03 |
| 1114404506 | Laura Ida Anthony-getant | Social Worker | 10130 Mallard Creek Road, Ste 300 #333, Charlotte, NC 28262 | 2018-07-27 |
| 1720573587 | Carolinas Center for Ambulatory Dentistry LLC | Dentist | 8415 Medical Plaza Drice, Charlotte, NC 28262 | 2018-06-25 |
| 1598254799 | Cassandra Faye Harding | Nurse Practitioner | 1905 Jn Pease Place Suite 103, Charlotte, NC 28262 | 2018-05-03 |
| 1669960746 | Michael Riley | In Home Supportive Care | 8301 University Exec Park Dr Ste 120, Charlotte, NC 28262 | 2018-04-25 |
| 1568989804 | Bridget Coomber | Behavior Technician | 8420 University Executive Dr Ste 810, Charlotte, NC 28262 | 2017-08-28 |
| 1073037701 | Toshana Daley | Physical Therapist | 8801 Jm Keynes Blvd, Charlotte, NC 28262 | 2017-08-03 |
| Find all providers in zip 28262 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962714279 | Saadia Khan Parker | Podiatrist | 447 E 12th St, Apt 201, Charlotte, NC 28206-0502 | 2010-07-02 |
| 1770795650 | Kathy A Henricksen | Podiatrist | 512 E Kingston Ave, Charlotte, NC 28203-5118 | 2007-05-04 |
| 1285759605 | First Care Medical Clinic | Podiatrist | 9040 Nations Ford Rd, Charlotte, NC 28273-5716 | 2007-03-21 |
| 1093877326 | Thomas P Whitfield | Podiatrist | 4444 Park Rd, Charlotte, NC 28209-3130 | 2006-12-14 |
| 1548351687 | Robert M Liesman | Podiatrist | 2115 E 7th St, Suite 102, Charlotte, NC 28204-3307 | 2006-09-27 |
| 1558332015 | Gregory H Colbert | Podiatrist | 436 W Lawrence Ave, Charlotte, MI 48813-1442 | 2006-01-31 |
| 1093799835 | Paul I Reiss | Podiatrist | 4915 Albemarle Rd, Charlotte, NC 28205-6617 | 2005-12-05 |
| 1164418406 | Kristine Marie Strauss | Podiatrist | 2550 W Arrowood Rd, Suite 102, Charlotte, NC 28273-6133 | 2005-09-22 |
| 1194718619 | John Michael Shimko | Podiatrist | 10130 Perimeter Pkwy Ste 200, Charlotte, NC 28216-0197 | 2005-08-30 |
| 1376043349 | Greater Charlotte Foot and Ankle | Podiatrist | 13425 Hoover Creek Blvd, Suite 201, Charlotte, NC 28273 | 2018-02-16 |
| Find all providers in CHARLOTTE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.