Active NPI
Amy Beth Vislisel, M.D.
- Pediatrics Physician
- Wyoming, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- FV3038165
- Practice address
- 5200 Fairview Blvd
Wyoming, MN 55092-8013 - Phone
- (651) 982-7000
- NPI assigned
- Jun 4, 2009
- Last updated
- Mar 9, 2013
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | FV3038165 | MN | Primary |
Addresses
Primary practice location
5200 Fairview Blvd
Wyoming, MN 55092-8013
Mailing address
5200 Fairview Blvd
Wyoming, MN 55092-8013
Phone (651) 982-7000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fairview Health Services | Current | Accepting new patients | |
| Fairview Clinics | Current | Accepting new patients | |
| Fairview Clinics | Current | Accepting new patients | |
| Fairview Clinics | Current | Accepting new patients | |
| Fairview Health Services | Current | Accepting new patients | |
| Fairview Clinics | Current | Accepting new patients | |
| Fairview Clinics | Past | Accepting new patients |
Locations
15650 Cedar Ave
Apple Valley, MN 55124
Phone (952) 997-4100
1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860
400 Stinson Blvd
Fl 2
Minneapolis, MN 55413
Phone (612) 672-2203
911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313
5200 Fairview Blvd
Wyoming, MN 55092
Phone (651) 464-4611
Interoperability endpoints
- avislisel5432@fairview.direct-ci.com
Organizations & group practices 8
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.
-
dba Fairview Clinics-Hiawatha
- Primary Care Clinic/Center
- Minneapolis, MN
- NPI 1346432218
-
- Emergency Medicine Physician
- Minneapolis, MN
- NPI 1811077175
-
dba Fairview Clinics-Rush City
- Primary Care Clinic/Center
- Rush City, MN
- NPI 1295989457
-
- Primary Care Clinic/Center
- Saint Paul, MN
- NPI 1396552147
-
dba Fairview Clinics-Rosemount
- Primary Care Clinic/Center
- Rosemount, MN
- NPI 1952548109
-
dba Fairview Hospital University
- General Acute Care Hospital
- Minneapolis, MN
- NPI 1013994359
-
dba Fairview Emergency Medical Services
- Land Ambulance
- Saint Paul, MN
- NPI 1710212485
-
dba Fairview Clinics-New Brighton
- Primary Care Clinic/Center
- New Brighton, MN
- NPI 1881673002
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1244073600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1362787200000",
"number": "1952537979",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5200 FAIRVIEW BLVD",
"city": "WYOMING",
"state": "MN",
"postal_code": "550928013",
"telephone_number": "651-982-7000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5200 FAIRVIEW BLVD",
"city": "WYOMING",
"state": "MN",
"postal_code": "550928013",
"telephone_number": "651-982-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VISLISEL",
"first_name": "AMY",
"middle_name": "BETH",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-06-04",
"last_updated": "2013-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MN",
"license": "FV3038165",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Wyoming, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2013; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.