Elizabeth Fay Wasylow

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

1-081299 Issued in AL

Practice address

1022 County Road 28
Scottsboro, AL 35768-6458

Phone

(256) 609-8023

NPI assigned

Feb 15, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AL

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

Interoperability endpoints

• Direct secure messaging: elizabeth.wasylow.1@22854.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 and National Provider Directory roles.

• Monogram Health Professional Services PC

  • Nephrology Physician
  • Brentwood, TN
  • NPI 1336748300

  AL

  Medicare reassignment

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

{
    "created_epoch": "1581724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639440000000",
    "number": "1417580705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1022 COUNTY ROAD 28",
            "city": "SCOTTSBORO",
            "state": "AL",
            "postal_code": "357686458",
            "telephone_number": "256-609-8023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1022 COUNTY ROAD 28",
            "city": "SCOTTSBORO",
            "state": "AL",
            "postal_code": "357686458",
            "telephone_number": "256-609-8023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASYLOW",
        "first_name": "ELIZABETH",
        "middle_name": "FAY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-15",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TN",
            "license": "27528",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AL",
            "license": "1-081299",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSING LICENSE",
            "identifier": "1-081299",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANCC",
            "identifier": "2019056163",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wal-Mart Stores East, LP
• Gene A Walker
• Kerry Dale Walker, CRNP
• Tony Benton Wallingsford, HIS
• Laura C Walls, FNP-C
• Lindsey Watkins, PHARM. D
• Donna Watson, C.R.N.P.
• James Donald Watson, O.D.
• Mavis L Webb, CRNA
• Andrew Oliver White, M.D.

• Acute Care Nurse Practitioner in Scottsboro, AL
• Providers in Scottsboro, AL by specialty
• Acute Care Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2021; 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.