Wogene Amsalu

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

2018001284 Issued in MO

Practice address

9628 Midland Blvd
Overland, MO 63114-3357

Phone

(314) 779-6022

NPI assigned

Aug 21, 2015

Last updated

May 11, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/25705/brand/1/csg/1/fhir/r4
• Direct secure messaging: wogene.amsalu.1@25705.direct.athenahealth.com

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.

• Liaison Health Group, LLC

  • Clinic/Center
  • Overland, MO
  • NPI 1033874888
  Medicare reassignment NPD Authorized official
• Washington University

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1760422265

  Primary Care

  Medicare reassignment NPD
• Midland Qualify Care

  • Home Health Agency
  • Saint Louis, MO
  • NPI 1982387791
  NPD Authorized official
• Midland Quality Care, LLC

  • Home Health Agency
  • Saint Louis, MO
  • NPI 1386429553
  NPD Authorized official
• Washington University

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1962442475
  NPD

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

{
    "created_epoch": "1440115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652227200000",
    "number": "1184091431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1131 INDIAN TRAILS DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631323109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9628 MIDLAND BLVD",
            "city": "OVERLAND",
            "state": "MO",
            "postal_code": "631143357",
            "telephone_number": "314-779-6022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMSALU",
        "first_name": "WOGENE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-21",
        "last_updated": "2022-05-11",
        "certification_date": "2022-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MO",
            "license": "2018001284",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2002031108",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret Stacey Albin-Wilson, DMD
• All Access Home Care Inc
• All in 1 Care Consumer Directed Services, LLC
• All Inclusive in Home Service LLC
• American Pathology Labs LLC
• Elizabeth Anderson, RBT
• Anns Touch Adult Daycare-2 LLC
• Wendy Lynne Apgar, M.S., OTR, L
• Julia Appel, RBT
• B&J Consumer Directed Service, LLC (Chosen Path)

• Primary Care Nurse Practitioner in Overland, MO
• Providers in Overland, MO by specialty
• Primary Care Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.