Individual provider Active NPI

Elizabeth Wilson, D.O.

  • Obstetrics & Gynecology Physician
  • Foley, AL
National Provider Identifier
1083077507
Registry record updated Jul 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
OS21802 Issued in FL
Practice address
1725 N McKenzie St
Foley, AL 36535-2249
Phone
(251) 943-2141
Fax
(251) 943-2846
NPI assigned
Apr 1, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X DO.1832 AL
Obstetrics & Gynecology Physician 207V00000X OS21802 FL Primary

Addresses

Primary practice location

1725 N McKenzie St
Foley, AL 36535-2249

Mailing address

2546 SW 74TH Ter
Davie, FL 33317-7028
Phone (954) 475-5758

Other identifiers 2

IdentifierTypeStateIssuer
253585MedicaidAL
252633MedicaidAL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address elizabeth.wilson.1@1599.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, FL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200720000943 AL Practitioner - Obstetrics/Gynecology 2365736477
I20250523000800 FL Practitioner - Obstetrics/Gynecology 2365736477 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Nova Southeastern College of Osteo Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pediatrix Medical Group of Florida IncGroup PAC ID 4486634417, 37 clinicians

Practice addresses (Care Compare)

2801 N St Rd
Suite 7
Margate, FL 33063-5727
Phone (954) 974-0400

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.97 of 100Reported as apm
Quality
75.95
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
DO.1832ALMDObstetrics & Gynecology Physician
OS21802FLMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatrix Medical Group of Florida Inc Obstetrics & Gynecology CurrentSince Sep 1, 2025 Accepting new patients
Foley Clinic Corp Past Accepting new patients
Foley Hospital Company LLC Past Accepting new patients

Locations

3476 S University Dr
Davie, FL 33328
Phone (954) 452-2107

2801 N State Road 7
Margate, FL 33063
Phone (954) 683-7041

3100 SW 62nd Ave
Miami, FL 33155
Phone (305) 669-5873

1901 SW 172nd Ave
Miramar, FL 33029
Phone (954) 276-5401

12969 S US 301
Riverview, FL 33578
Phone (813) 971-6909

3030 W Mlk Blvd
Tampa, FL 33607
Phone (813) 870-4000

Interoperability endpoints

  • Direct secure messaging: elizabeth.wilson.1@1599.direct.athenahealth.com

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1459468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752710400000",
    "number": "1083077507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2546 SW 74TH TER",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333177028",
            "telephone_number": "954-475-5758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 N MCKENZIE ST",
            "city": "FOLEY",
            "state": "AL",
            "postal_code": "365352249",
            "telephone_number": "251-943-2141",
            "fax_number": "251-943-2846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "ELIZABETH",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-01",
        "last_updated": "2025-07-17",
        "certification_date": "2025-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AL",
            "license": "DO.1832",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "OS21802",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "253585",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "252633",
            "state": "AL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "elizabeth.wilson.1@1599.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR Direct Address",
            "address_1": "1725 N McKenzie St",
            "city": "Foley",
            "state": "AL",
            "country_code": "US",
            "postal_code": "365352249",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Foley, AL

Sources for this page

Verify at the official NPI Registry.