Active NPI
Michael William Wasowicz, APRN
- Family Nurse Practitioner
- Elizabeth City, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 5011826
- Practice address
- 3815 Conlon Way
Elizabeth City, NC 27909 - Phone
- (252) 580-2002
- NPI assigned
- Aug 14, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 5011826 | NC | Primary |
| Family Nurse Practitioner | 363LF0000X | AP7739 | AZ |
Addresses
Primary practice location
3815 Conlon Way
Elizabeth City, NC 27909
Mailing address
PO Box 2789
Kitty Hawk, NC 27949-2789
Phone (928) 231-1859
Other practice location 1
315 Greenville Blvd SE Ste 100
Greenville, NC 27858-5733
Phone (252) 917-5621
Other practice location 2
9340 East Redfield Road
Scottsdale, AZ 85260
Phone (410) 948-0373
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC, MD, TX, NC, VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 5
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1944 Centerville Tpke
Suite 100
Virginia Beach, VA 23464-6839
Phone (757) 362-9067
3815 Conlon Way
Elizabeth City, NC 27909-9999
Phone (252) 580-2002
500 N Indiana Ave
Winslow, AZ 86047-2169
Phone (928) 289-4646
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP7739 | AZ | MD | Family Nurse Practitioner |
| 5011826 | NC | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dilkon Medical Center | Current | Accepting new patients | |
| Winslow Indian Health Care Center, Inc | Current | Accepting new patients | |
| DHHS IHS Phoenix Area | Current | Accepting new patients | |
| DHHS IHS Phoenix Area | Current | Accepting new patients | |
| Winslow Indian Health Care Center, Inc | Current | Accepting new patients | |
| Velocity Urgent Care, LLC | Current | Accepting new patients | |
| Velocity Urgent Care LLC | Current | Accepting new patients | |
| DHHS IHS Phoenix Area | Current | Accepting new patients | |
| DHHS IHS Phoenix Area | Current | Accepting new patients | |
| Winslow Indian Health Care Center, Inc | Current | Accepting new patients | |
| Fastmed P.C. | Current | Accepting new patients | |
| Arizona Pulmonary Specialists LTD | Past | Accepting new patients | |
| Fastmed Primary Care, P.C. | Past | Accepting new patients |
Locations
12033 Agency Rd
Parker, AZ 85344
Phone (760) 572-4137
500 Indiana Ave
Winslow, AZ 86047
1501 N Williamson Ave
Winslow, AZ 86047
Phone (928) 289-4691
178 Highway 105 Ext
Ste 101
Boone, NC 28607
Phone (828) 265-7146
7010 NC Highway 751
Durham, NC 27707
Phone (919) 313-3900
3815 Conlon Way
Elizabeth City, NC 27909
Phone (252) 580-2002
315 Greenville Blvd SE
Ste 100
Greenville, NC 27858
Phone (252) 917-5621
1944 Centerville Tpke
Ste 100
Virginia Beach, VA 23464
Phone (757) 362-9067
4374 New Town Ave
Williamsburg, VA 23188
Phone (757) 772-6124
Interoperability endpoints
- https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71750
Organizations & group practices 14
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.
-
- Federal Public Health Clinic/Center
- Winslow, AZ
- NPI 1184729493
TX
-
- Family Medicine Physician
- Durham, NC
- NPI 1629841788
-
- Clinic/Center
- Cibecue, AZ
- NPI 1427335181
-
- Critical Access Hospital
- Parker, AZ
- NPI 1851678585
-
- Federal Public Health Clinic/Center
- Dilkon, AZ
- NPI 1306016126
-
- Clinic/Center
- Virginia Beach, VA
- NPI 1194561738
-
- Land Ambulance
- Winslow, AZ
- NPI 1477827368
-
- Federal Public Health Clinic/Center
- Leupp, AZ
- NPI 1760652580
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1743033600000",
"number": "1922407063",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2789",
"city": "KITTY HAWK",
"state": "NC",
"postal_code": "279492789",
"telephone_number": "928-231-1859"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3815 CONLON WAY",
"city": "ELIZABETH CITY",
"state": "NC",
"postal_code": "27909",
"telephone_number": "252-580-2002"
}
],
"practiceLocations": [
{
"address_1": "315 Greenville Blvd SE Ste 100",
"address_purpose": "LOCATION",
"city": "Greenville",
"state": "NC",
"postal_code": "278585733",
"country_code": "US",
"telephone_number": "252-917-5621",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "9340 East Redfield Road",
"address_purpose": "LOCATION",
"city": "Scottsdale",
"state": "AZ",
"postal_code": "85260",
"country_code": "US",
"telephone_number": "410-948-0373",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WASOWICZ",
"first_name": "MICHAEL",
"middle_name": "WILLIAM",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-08-14",
"last_updated": "2025-03-27",
"certification_date": "2025-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NC",
"license": "5011826",
"primary": true
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "AZ",
"license": "AP7739",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Elizabeth City, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 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.