Individual provider Active NPI

Alyson G Wolz, APRN, CNS, BC

  • Adult Psychiatric/Mental Health Clinical Nurse Specialist
  • Carbondale, IL
National Provider Identifier
1003031576
Registry record updated Feb 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0809X
License
277000503 Issued in IL
Practice address
8714 Day Rd
Carbondale, IL 62902-0427
Phone
(618) 559-3319
Fax
(618) 457-5372
NPI assigned
Apr 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Psychiatric/Mental Health Clinical Nurse Specialist 364SP0809X T152855 IA
Adult Psychiatric/Mental Health Clinical Nurse Specialist 364SP0809X 277000503 IL Primary

Addresses

Primary practice location

8714 Day Rd
Carbondale, IL 62902-0427

Mailing address

8714 Day Rd
Carbondale, IL 62902-0427
Phone (618) 559-3319

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20040707000089 IL Practitioner - Certified Clinical Nurse Specialist (CNS) 1355328675 Practice locations: Carbondale, IL

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist

State licenses

LicenseStateTypeSpecialty
T152855IAMDAdult Psychiatric/Mental Health Clinical Nurse Specialist
277000503ILMDAdult Psychiatric/Mental Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Holistic Psychiatry Inc Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://epicproxy.et0986.epichosted.com/FHIRProxy/api/FHIR/R4/

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": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707436800000",
    "number": "1003031576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8714 DAY RD",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629020427",
            "telephone_number": "618-559-3319",
            "fax_number": "618-457-5372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8714 DAY RD",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629020427",
            "telephone_number": "618-559-3319",
            "fax_number": "618-457-5372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLZ",
        "first_name": "ALYSON",
        "middle_name": "G",
        "name_prefix": "Mrs.",
        "credential": "APRN, CNS, BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-17",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "IA",
            "license": "T152855",
            "primary": false
        },
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "IL",
            "license": "277000503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carbondale, IL

Sources for this page

Verify at the official NPI Registry.