Audrey B.R. Vanwylen, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

50473 Issued in TN

Practice address

2861 Broad Ave
Memphis, TN 38112-2903

Phone

(901) 701-2520

Fax

(901) 325-6469

NPI assigned

Jul 8, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Miss Audrey B Richardson Former name

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

University of Michigan Medical School, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Christ Community Health Services Inc.Group PAC ID 3870402084, 61 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: audrey.vanwylen@christchs.eclinicaldirectplus.com

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.

• Christ Community Health Services Inc

  • Federally Qualified Health Center (FQHC)
  • Memphis, TN
  • NPI 1982686614
  Medicare reassignment Care Compare group NPD
• Christ Community Health Services Inc

  • Federally Qualified Health Center (FQHC)
  • Jackson, TN
  • NPI 1871299297
  NPD
• Christ Community Health Services Inc.

  • Federally Qualified Health Center (FQHC)
  • Memphis, TN
  • NPI 1972892727
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1278547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427673600000",
    "number": "1982916896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2595 CENTRAL AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381045905",
            "telephone_number": "901-260-8500",
            "fax_number": "901-260-8598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2861 BROAD AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381122903",
            "telephone_number": "901-701-2520",
            "fax_number": "901-325-6469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANWYLEN",
        "first_name": "AUDREY",
        "middle_name": "B.R.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-08",
        "last_updated": "2015-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4301096247",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "50473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AUDREY",
            "last_name": "RICHARDSON",
            "middle_name": "B",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lisa Vanhouwelingen, M.D.
• Miriam Vanmersbergen, SLP
• Beverly Ann Vann, LASW
• Kimberly Nicole Vann, FNP-BC
• Kevin Harold Vantrees, RPA, R.T. (R)(MR)(CT
• Rebecca Vanzant, M.D.
• Stephanie Schultz Vanzant, APRN
• Kaushik Varadarajan, MD
• Varangon Incorporated
• Kathryn S. Varela, MA, CCC/SLP

• Family Medicine Physician in Memphis, TN
• Providers in Memphis, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2015; 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.

Verify at the official NPI Registry.