Individual provider Active NPI

Elizabeth Natalie Vallot, AGCNS-BC

  • Clinical Nurse Specialist
  • Kyle, TX
National Provider Identifier
1124691308
Registry record updated Jul 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Nurse SpecialistTaxonomy code 364S00000X
License
1048214 Issued in TX
Practice address
6001 Kyle Pkwy
Kyle, TX 78640-6112
Phone
(512) 504-5000
NPI assigned
Jul 23, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Nurse Specialist 364S00000X 1048214 TX Primary

Addresses

Primary practice location

6001 Kyle Pkwy
Kyle, TX 78640-6112

Mailing address

1108 Lavaca St Ste 110-320
Austin, TX 78701-2172
Phone (512) 477-4088

Other practice location 1

1108 Lavaca St Ste 110-320
Austin, TX 78701-2172
Phone (512) 477-4088

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20210820003021 TX Practitioner - Nurse Practitioner 5991100489 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Austin Geriatric Specialists PLLCGroup PAC ID 5092770511, 59 clinicians

Practice addresses (Care Compare)

1108 Lavaca St
Suite 110 320
Austin, TX 78701-2172
Phone (512) 477-4088

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1048214TXMDClinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Austin Geriatric Specialists, PLLC CurrentSince Aug 1, 2021 Accepting new patients
Hni Medical Services PastSince Jul 25, 2021 Accepting new patients

Locations

1108 Lavaca St
Ste 110320
Austin, TX 78701
Phone (512) 482-0390

11406 Rustic Rock Dr
Austin, TX 78750
Phone (512) 251-3915

Interoperability endpoints

  • Direct secure messaging: elizabeth.vallot.1@25850.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/18292/brand/1/csg/1/fhir/r4
  • FHIR API: https://api.platform.athenahealth.com/25850/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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": "1626998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626998400000",
    "number": "1124691308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1108 LAVACA ST STE 110-320",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787012172",
            "telephone_number": "512-477-4088",
            "fax_number": "512-482-0390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6001 KYLE PKWY",
            "city": "KYLE",
            "state": "TX",
            "postal_code": "786406112",
            "telephone_number": "512-504-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1108 Lavaca St Ste 110-320",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787012172",
            "country_code": "US",
            "telephone_number": "512-477-4088",
            "fax_number": "512-482-0390",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VALLOT",
        "first_name": "ELIZABETH",
        "middle_name": "NATALIE",
        "credential": "AGCNS-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-23",
        "last_updated": "2021-07-23",
        "certification_date": "2021-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "TX",
            "license": "1048214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kyle, TX

Sources for this page

Verify at the official NPI Registry.