Active NPI
Vickie D Sconyers, CRNP
- Nurse Practitioner
- Dothan, AL
National Provider Identifier
1023069903
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 1029189
- Practice address
- 4300 West Main St
Womens Healthcare of Dothan PC Ste 31
Dothan, AL 36305-4300 - Phone
- (334) 793-6511
- Fax
- (334) 677-5642
- NPI assigned
- May 15, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 1029189 | AL | Primary |
Addresses
Primary practice location
4300 West Main St
Womens Healthcare of Dothan PC Ste 31
Dothan, AL 36305-4300
Mailing address
4300 West Main St
Ste 31
Dothan, AL 36305-4300
Phone (334) 793-6511
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000029327 | Medicaid | AL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1029189 | AL | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147651200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1268265600000",
"number": "1023069903",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4300 WEST MAIN ST",
"address_2": "STE 31",
"city": "DOTHAN",
"state": "AL",
"postal_code": "363054300",
"telephone_number": "334-793-6511",
"fax_number": "334-677-5642"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4300 WEST MAIN ST",
"address_2": "WOMENS HEALTHCARE OF DOTHAN PC STE 31",
"city": "DOTHAN",
"state": "AL",
"postal_code": "363054300",
"telephone_number": "334-793-6511",
"fax_number": "334-677-5642"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCONYERS",
"first_name": "VICKIE",
"middle_name": "D",
"credential": "CRNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-15",
"last_updated": "2010-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "AL",
"license": "1029189",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000029327",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dothan, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.