Individual provider Active NPI

Phyllis Alexander, FNP

  • Family Nurse Practitioner
  • Gladys, VA
National Provider Identifier
1902693740
Registry record updated May 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024192928 Issued in VA
Practice address
PO Box 112
Gladys, VA 24554-0112
Phone
(434) 941-1212
NPI assigned
Apr 24, 2025
Last updated
May 13, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024192928 VA Primary

Addresses

Primary practice location

PO Box 112
Gladys, VA 24554-0112

Mailing address

PO Box 112
Gladys, VA 24554-0112
Phone (434) 941-1212

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250904002493 VA Practitioner - Nurse Practitioner 9133484249 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Halifax Heart Center PCGroup PAC ID 7911992722, 5 clinicians

Practice addresses (Care Compare)

2232 Wilborn Ave
Suite a
South Boston, VA 24592-1662
Phone (434) 572-8977

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Halifax Heart Center PC CurrentSince Aug 4, 2025 Accepting new patients

Locations

2232 Wilborn Ave
Ste A
South Boston, VA 24592
Phone (434) 572-8977

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1745452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747094400000",
    "number": "1902693740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 112",
            "city": "GLADYS",
            "state": "VA",
            "postal_code": "245540112",
            "telephone_number": "434-941-1212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 112",
            "city": "GLADYS",
            "state": "VA",
            "postal_code": "245540112",
            "telephone_number": "434-941-1212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALEXANDER",
        "first_name": "PHYLLIS",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-04-24",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024192928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gladys, VA

Sources for this page

Verify at the official NPI Registry.