Edwan Tifuh Mayo, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0024173580 Issued in VA

Practice address

1871 Ivystone CT
Henrico, VA 23238-4213

Phone

(218) 207-8373

NPI assigned

May 20, 2016

Sex

Female

Sole proprietor

Yes

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

May accept Medicare assignment

Group practices

Legacy Care Aco LLCGroup PAC ID 3274996426, 36 clinicians

Legacy Care LLCGroup PAC ID 0042458200, 42 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mayomedicalpracticellc.edwankibot@147760.advancedmd-direct.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.

• Forecast Medical Practice LLC

  • Family Health Clinical Nurse Specialist
  • Colonial Heights, VA
  • NPI 1891391843
  Medicare reassignment NPD Authorized official
• Alexandria Springfield Emergency Physicians PC

  • Emergency Medicine Physician
  • Franklin, VA
  • NPI 1740529700
  Medicare reassignment NPD
• Emergency Medicine Associates, P.a.,P.C.

  • Internal Medicine Physician
  • Dulles, VA
  • NPI 1376917070
  Medicare reassignment NPD
• Southeastern Intensivist Services PC

  • Hospitalist Physician
  • West Memphis, AR
  • NPI 1912942665

  VA

  Medicare reassignment NPD
• Legacy Care Aco LLC

  • Family Medicine Physician
  • Virginia BCH, VA
  • NPI 1538844857
  Care Compare group
• Legacy Care LLC

  • Family Medicine Physician
  • Virginia Beach, VA
  • NPI 1902149776
  Care Compare group
• Alexandria Springfield Emergency Physicians PC

  • Emergency Medicine Physician
  • Alexandria, VA
  • NPI 1720839764
  NPD
• Emergency Medicine Associates P.a., P.C.

  • Internal Medicine Physician
  • Culpeper, VA
  • NPI 1881559102
  NPD
• Dominion Heart and Vascular Clinic

  • Interventional Cardiology Physician
  • Colonial Heights, VA
  • NPI 1356789010
  NPD (past)
• Kurt R. Jung, Optometrist & Associates PLLC

  • Optometrist
  • Midlothian, VA
  • NPI 1699276998
  NPD (past)
• Arnot Medical Services PLLC

  • Internal Medicine Physician
  • Elmira, NY
  • NPI 1427326768
  NPD (past)

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

{
    "created_epoch": "1463702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1508213398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1871 IVYSTONE CT",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232384213",
            "telephone_number": "218-207-8373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1871 IVYSTONE CT",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232384213",
            "telephone_number": "218-207-8373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYO",
        "first_name": "EDWAN",
        "middle_name": "TIFUH",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-20",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024173580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maximal Business Healthcare Services, LLC
• Briann Maxwell
• Brian Michael Mayer, LCSW
• Sarah Mayfield
• Andrea L. Mayo, NP
• Lawanda Mayo
• Lenise Benzina Mazyck, LCSW
• Joanna Woodward McAbee, PMHNP
• Sydney Kathleen McAdams, RESIDENT LPC
• Robert McAllister

• Family Nurse Practitioner in Henrico, VA
• Providers in Henrico, VA by specialty
• Family Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2024; 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.