Active NPI
Alyis Wilborn
- Registered Nurse
- Chillicothe, OH
National Provider Identifier
1760100309
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- RN305871
- Practice address
- 17273 State Route 104
Chillicothe, OH 45601-9718 - Phone
- (740) 773-1141
- NPI assigned
- Aug 19, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN305871 | OH | Primary |
Addresses
Primary practice location
17273 State Route 104
Chillicothe, OH 45601-9718
Mailing address
17273 State Route 104
Chillicothe, OH 45601-9718
Phone (740) 773-1141
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RN305871 | Other | OH | BLUE CROSS BLUE SHIELD |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | Alyis.Wilborn@va.gov | ||
| Direct Messaging Address | Alyis.Wilborn@va.gov |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN305871 | OH | MD | Registered Nurse |
Interoperability endpoints
- alyis.wilborn@va.gov
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1660867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660867200000",
"number": "1760100309",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17273 STATE ROUTE 104",
"city": "CHILLICOTHE",
"state": "OH",
"postal_code": "456019718",
"telephone_number": "740-773-1141"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17273 STATE ROUTE 104",
"city": "CHILLICOTHE",
"state": "OH",
"postal_code": "456019718",
"telephone_number": "740-773-1141"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILBORN",
"first_name": "ALYIS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-08-19",
"last_updated": "2022-08-19",
"certification_date": "2022-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "OH",
"license": "RN305871",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "RN305871",
"state": "OH"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "Alyis.Wilborn@va.gov",
"affiliation": "N",
"endpointDescription": "email",
"address_1": "17273 State Route 104",
"city": "Chillicothe",
"state": "OH",
"country_code": "US",
"postal_code": "456019718",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "Alyis.Wilborn@va.gov",
"affiliation": "N",
"address_1": "17273 State Route 104",
"city": "Chillicothe",
"state": "OH",
"country_code": "US",
"postal_code": "456019718",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Chillicothe, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.