Individual provider Active NPI

Elizabeth D Nowalk, NP

  • Nurse Practitioner
  • Burlington, VT
National Provider Identifier
1407418478
Registry record updated Aug 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
101.0135007 Issued in VT
Practice address
617 Riverside Ave
Burlington, VT 05401-1601
Phone
(802) 864-6309
NPI assigned
Jul 1, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F344654 NY
Nurse Practitioner 363L00000X 101.0135007 VT Primary

Addresses

Primary practice location

617 Riverside Ave
Burlington, VT 05401-1601

Mailing address

617 Riverside Ave
Burlington, VT 05401-1601
Phone (802) 864-6309

Other practice location 1

1780 Hanshaw Rd
Ithaca, NY 14850-9105
Phone (607) 257-5858

Other practice location 2

789 Pine St
Burlington, VT 05401-4924
Phone (802) 864-0693

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address enowalk12589@direct-guthrie.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, VT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190826000906 NY Practitioner - Nurse Practitioner 7719215045 Reassigns benefits to 1 organization
I20220817003425 VT Practitioner - Nurse Practitioner 7719215045 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Health Centers of Burlington IncGroup PAC ID 2062491251, 84 clinicians

Practice addresses (Care Compare)

617 Riverside Ave
Burlington, VT 05401-1601
Phone (802) 864-6309

Hospital & facility affiliations

  • Univ. of Vermont - Fletcher Allen Health Care Hospital, Burlington, VT, CCN 470003

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F344654NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Centers of Burlington Inc CurrentSince Apr 13, 2022 Accepting new patients
Guthrie Medical Group, P.C. CurrentSince Aug 1, 2019 Accepting new patients
Guthrie Medical Group, P.C. CurrentSince Aug 1, 2019 Accepting new patients
Community Health Centers of Burlington Inc CurrentSince Apr 13, 2022 Accepting new patients
Community Health Centers of Burlington Inc Past Accepting new patients
University of Vermont Medical Center Inc Past Accepting new patients

Locations

130 Center Way
Corning, NY 14830
Phone (607) 936-9971

1780 Hanshaw Rd
Ithaca, NY 14850
Phone (607) 257-5858

1 Guthrie Sq
Sayre, PA 18840
Phone (570) 887-3106

617 Riverside Ave
Ste 200
Burlington, VT 05401

789 Pine St
Burlington, VT 05401
Phone (802) 264-1052

617 Riverside Ave
Burlington, VT 05401
Phone (802) 264-8158

Interoperability endpoints

  • Direct secure messaging: elizabeth.nowalk.p1@direct.chcb.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: enowalk12589@direct-guthrie.org

Organizations & group practices 6

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": "1561939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755561600000",
    "number": "1407418478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 RIVERSIDE AVE",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054011601",
            "telephone_number": "802-864-6309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 RIVERSIDE AVE",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054011601",
            "telephone_number": "802-864-6309"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1780 Hanshaw Rd",
            "address_purpose": "LOCATION",
            "city": "Ithaca",
            "state": "NY",
            "postal_code": "148509105",
            "country_code": "US",
            "telephone_number": "607-257-5858",
            "fax_number": "607-257-1718",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "789 Pine St",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "VT",
            "postal_code": "054014924",
            "country_code": "US",
            "telephone_number": "802-864-0693",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOWALK",
        "first_name": "ELIZABETH",
        "middle_name": "D",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-01",
        "last_updated": "2025-08-19",
        "certification_date": "2025-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F344654",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VT",
            "license": "101.0135007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "enowalk12589@direct-guthrie.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1780 Hanshaw Rd",
            "city": "Ithaca",
            "state": "NY",
            "country_code": "US",
            "postal_code": "148509105",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Burlington, VT

Sources for this page

Verify at the official NPI Registry.