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JESSE VILLANUEVA
NPI 1255737631
Nurse Practitioner - Family in Charlotte, NC

Active since November 12, 2014
200 SOUTH COLLEGE STREET, SUITE 500, CHARLOTTE, NC 28202(704) 302-8800(704) 632-4001 Get Directions Write a Review

NPPES record last updated: March 3, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 3, 2017, Oct 19, 2016 (2 updates tracked since 2016).

About Jesse Villanueva NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JESSE VILLANUEVA (NPI 1255737631) is an individual family provider in Charlotte, North Carolina, licensed in Connecticut (5841) and active in the NPI registry since November 2014.

NPPES Registry Identity

NPI1255737631
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameJESSE VILLANUEVA
Location Address200 SOUTH COLLEGE STREET, SUITE 500Charlotte, NC 28202-2067
Mailing AddressP.o.box 601643Charlotte, NC 28260-1643 · (704) 302-8800 · Fax (704) 632-4001
Phone(704) 302-8800
Fax(704) 632-4001
Sole ProprietorNo
Enumeration DateNovember 12, 2014
Last NPPES UpdateMarch 3, 20172 updates tracked since enumeration
✔ NPI 1255737631 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
Licenses✔ Licensed in CT · 5841✔ Licensed in NC · 285489✔ Licensed in NC · 5008751
200 SOUTH COLLEGE STREET, Charlotte, NC 28202
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Other Identifiers 3

Medicaid1255737631NC
MedicaidNP4174SC
Medicare PINNCV275ANC

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MECKLENBURG MEDICAL GROUP
Internal Medicine
200 SOUTH COLLEGE STREET, SUITE 500
CHARLOTTE, NC 28202
Mecklenburg County (704) 302-8800

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jesse Villanueva's NPI number?

The NPI number for Jesse Villanueva is 1255737631. It was assigned to this individual provider in the NPPES registry on November 12, 2014.

Where is Jesse Villanueva located?

Jesse Villanueva practices at 200 South College Street Suite 500, Charlotte, NC 28202. The listed phone number is (704) 302-8800.

What is Jesse Villanueva's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Jesse Villanueva was last updated on March 3, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.