Nicole Alexandra Fazekas-Woolwine, DO

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

0102209294 Issued in VA

Practice address

606 E Stuart Dr
Galax, VA 24333-2317

Phone

(276) 236-8166

NPI assigned

Mar 24, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Pediatric Medicine

Education

Edward Via Col of Osteo Medicine-Virginia Campus, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nicole.fazekas-woolwine.1@10112.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.

• DLP Twin County Physician Practices LLC

  • Sleep Medicine (Psychiatry & Neurology) Physician
  • Galax, VA
  • NPI 1962078527
  Medicare reassignment NPD
• DLP Twin County Physician Practices LLC

  • Surgery Physician
  • Galax, VA
  • NPI 1033485925
  NPD
• DLP Twin County Physician Practices LLC

  • Pediatrics Physician
  • Galax, VA
  • NPI 1619243300
  NPD
• DLP Twin County Physician Practices LLC

  • Family Medicine Physician
  • Galax, VA
  • NPI 1235404047
  NPD (past)

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

{
    "created_epoch": "1648080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760054400000",
    "number": "1437809316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "606 E STUART DR",
            "city": "GALAX",
            "state": "VA",
            "postal_code": "243332317",
            "telephone_number": "276-236-8166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 E STUART DR",
            "city": "GALAX",
            "state": "VA",
            "postal_code": "243332317",
            "telephone_number": "276-236-8166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAZEKAS-WOOLWINE",
        "first_name": "NICOLE",
        "middle_name": "ALEXANDRA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-24",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0102209294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emergency Physicians of Southern Virginia LLP
• Kendra Paige Endicott, PHARMACIST
• Eshcol Brook Homes, LLC
• Family Preservation Services, Inc
• Family Preservation Services, Inc
• Felts Supports for Living, LLC
• Todd Barton Fichtel, D.C.
• First Choice Health Care LLC
• Heather Flippin
• Erica Poe Forrester, PT, DPT

• Pediatrics Physician in Galax, VA
• Providers in Galax, VA by specialty
• Pediatrics Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.