Active NPI
Elizabeth Diane Gwin, NP
- Nurse Practitioner
- Strafford, MO
National Provider Identifier
1154839843
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 2018001289
- Practice address
- 5604 E Park PL
Strafford, MO 65757-9057 - Phone
- (417) 299-0767
- NPI assigned
- Jan 16, 2018
- Last updated
- Jan 31, 2023
- 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 | 2018001289 | MO | Primary |
Addresses
Primary practice location
5604 E Park PL
Strafford, MO 65757-9057
Mailing address
5604 E Park PL
Strafford, MO 65757-9057
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 420051021 | Medicaid | MO |
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
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ozarks Medical Center | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Ozarks Healthcare
- General Acute Care Hospital
- West Plains, MO
- NPI 1831115641
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1516060800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675123200000",
"number": "1154839843",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5604 E PARK PL",
"city": "STRAFFORD",
"state": "MO",
"postal_code": "657579057"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5604 E PARK PL",
"city": "STRAFFORD",
"state": "MO",
"postal_code": "657579057",
"telephone_number": "417-299-0767"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GWIN",
"first_name": "ELIZABETH",
"middle_name": "DIANE",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-01-16",
"last_updated": "2023-01-31",
"certification_date": "2023-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MO",
"license": "2018001289",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "420051021",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Strafford, MO
- Judith Anne Dasovich, MD
- Heidi Laine Facklam, OTR/L
- Fair Haven Children's Home
- Family Pharmacy of Strafford Inc. (Family Pharmacy #2)
- Mallory Quinn Foley, FNP-C
- Dana Marie Jackson, DMD
- Justified Living, LLC
- Christopher David Kollmeyer, DMD
- Lester E Cox Medical Centers (Coxhealth School Based Telemedicine)
- Whitney Page Lewis, M.S. CCC-SLP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.