Individual provider Active NPI

Elizabeth Marie Fagiolo, FNP, AG-ACNP-BC

  • Family Nurse Practitioner
  • Columbia, MO
National Provider Identifier
1689038101
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2016028015 Issued in MO
Practice address
601 W Business Loop 70 Ste 275
Columbia, MO 65203-2522
Phone
(573) 874-0008
Fax
(573) 875-5350
NPI assigned
Apr 11, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2016028015 MO Primary
Gerontology Nurse Practitioner 363LG0600X 2016028014 MO

Addresses

Primary practice location

601 W Business Loop 70 Ste 275
Columbia, MO 65203-2522

Mailing address

601 W Business Loop 70 Ste 275
Columbia, MO 65203-2522
Phone (573) 874-0008

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
I20160823001912 MO Practitioner - Nurse Practitioner 8729373220 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boone Physician Services LLCGroup PAC ID 6507090644, 243 clinicians

Practice addresses (Care Compare)

601 W Business Loop
70 Suite 275
Columbia, MO 65203-2522
Phone (573) 874-0008

Hospital & facility affiliations

  • Boone Hospital Center Hospital, Columbia, MO, CCN 260068

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2016028015MOMDFamily Nurse Practitioner
2016028014MOMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Boone Physician Services, LLC CurrentSince Jul 5, 2022 Accepting new patients
Southeastern Emergency Services of Memphis, P.C. Nurse Practitioner CurrentSince Aug 1, 2018 Accepting new patients
Providence Urgent Care LLC CurrentSince Oct 30, 2018 Accepting new patients

Locations

403 N Stadium Blvd
Ste 104
Columbia, MO 65203
Phone (573) 514-6271

1705 E Broadway
Ste 280
Columbia, MO 65201
Phone (573) 815-7119

900 W Nifong Blvd
Ste 100
Columbia, MO 65203
Phone (573) 815-6631

202 E Nifong Blvd
Columbia, MO 65203
Phone (573) 874-6824

601 W Business Loop 70
Ste 275
Columbia, MO 65203
Phone (573) 874-0008

1600 E Broadway
Columbia, MO 65201
Phone (573) 632-5000

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 2

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": "1460332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741910400000",
    "number": "1689038101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 W BUSINESS LOOP 70 STE 275",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652032522",
            "telephone_number": "573-874-0008",
            "fax_number": "573-875-5350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 W BUSINESS LOOP 70 STE 275",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652032522",
            "telephone_number": "573-874-0008",
            "fax_number": "573-875-5350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAGIOLO",
        "first_name": "ELIZABETH",
        "middle_name": "MARIE",
        "credential": "FNP, AG-ACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-11",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2016028015",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MO",
            "license": "2016028014",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.