Individual provider Active NPI

Ewa Vaizers, FNP-C

  • Family Nurse Practitioner
  • Saint Peters, MO
National Provider Identifier
1326876236
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2024029374 Issued in MO
Practice address
6 Jungermann Cir Ste 210
Saint Peters, MO 63376-1625
Phone
(636) 441-6056
Fax
(636) 441-0620
NPI assigned
Jul 23, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 2024029374 MO Primary

Addresses

Primary practice location

6 Jungermann Cir Ste 210
Saint Peters, MO 63376-1625

Mailing address

11133 Dunn Rd Ste 2335
Saint Louis, MO 63136-6165
Phone (314) 653-5007

Other practice location 1

11133 Dunn Rd Ste 2335
Saint Louis, MO 63136-6165
Phone (314) 653-5007

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240906003118 MO Practitioner - Nurse Practitioner 6204376072 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Hospital PerryGroup PAC ID 1153777826, 115 clinicians

Practice addresses (Care Compare)

12 N Kingshighway
100 Wound Care
Perryville, MO 63775-1367
Phone (573) 768-3399

1508 Edgemont Blvd
Primary Care/Convenient Care
Perryville, MO 63775-1231
Phone (573) 768-3220

206 Hospital LN
Perryville, MO 63775-1382

210 Hospital LN
Perryville, MO 63775-4200

210 Hospital LN
Suite 203
Perryville, MO 63775-1276
Phone (573) 768-3285

212 Hospital LN
Perryville, MO 63775-4204

434 N W St
Perryville, MO 63775-1359
Phone (573) 547-2536

624 Old Saint Marys Rd
Suite a
Perryville, MO 63775-1844
Phone (573) 768-3284

Hospital & facility affiliations

  • Mercy Hospital Perry Hospital, Perryville, MO, CCN 261311

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2024029374MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital Perry Single Specialty Current Accepting new patients
Mercy Hospital Perry CurrentSince Nov 3, 2024 Accepting new patients

Locations

434 N West St
Perryville, MO 63775
Phone (573) 547-2530

206 Hospital Ln
Ste 204
Perryville, MO 63775
Phone (573) 547-4899

Interoperability endpoints

  • Direct secure messaging: evaizers228199@direct-ehr-ssmhc.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": "1721692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1326876236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11133 DUNN RD STE 2335",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631366165",
            "telephone_number": "314-653-5007",
            "fax_number": "314-455-8001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 JUNGERMANN CIR STE 210",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633761625",
            "telephone_number": "636-441-6056",
            "fax_number": "636-441-0620"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11133 Dunn Rd Ste 2335",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631366165",
            "country_code": "US",
            "telephone_number": "314-653-5007",
            "fax_number": "314-455-8001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAIZERS",
        "first_name": "EWA",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-23",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2024029374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Peters, MO

Sources for this page

Verify at the official NPI Registry.