Individual provider Active NPI

Virginia C Wiley, M.D.

  • Family Medicine Physician
  • Walkersville, MD
National Provider Identifier
1023099033
Registry record updated Aug 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
D0063227 Issued in MD
Practice address
19 W Frederick St
Walkersville, MD 21793-8230
Phone
(301) 845-6336
Fax
(240) 578-4478
NPI assigned
Nov 7, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X D0063227 MD Primary

Addresses

Primary practice location

19 W Frederick St
Walkersville, MD 21793-8230

Mailing address

610 Solarex CT
Frederick, MD 21703-8624

Other identifiers 2

IdentifierTypeStateIssuer
926580505MedicaidMD
926580506MedicaidMD

Other names 1

  • Ginger C Wiley Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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

Enrollment IDStateProvider typePAC IDDetails
I20051007000740 MD Practitioner - Family Practice 1153346283 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0063227MDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC Family Medicine CurrentSince Oct 12, 2016 Accepting new patients
Privia Care Center LLC CurrentSince Oct 4, 2018 Accepting new patients
Menocal Medical Services PA Family Medicine Current Accepting new patients
Privia Care Center LLC Current Accepting new patients
Privia Medical Group, LLC CurrentSince Oct 12, 2016 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

133 Defense Hwy
Ste 112
Annapolis, MD 21401
Phone (410) 573-0140

301 Saint Paul St
Ste 409
Baltimore, MD 21202
Phone (410) 659-7041

610 Solarex Ct
Frederick, MD 21703
Phone (301) 663-6162

110 Baughmans Ln
Ste 140
Frederick, MD 21702
Phone (240) 215-1138

610 Solarex Ct
#2
Frederick, MD 21703

11350 Pembrooke Sq
Ste 304
Waldorf, MD 20603
Phone (301) 856-2810

19 W Frederick St
Walkersville, MD 21793
Phone (301) 662-8541

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470096000000",
    "number": "1023099033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 SOLAREX CT",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217038624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 W FREDERICK ST",
            "city": "WALKERSVILLE",
            "state": "MD",
            "postal_code": "217938230",
            "telephone_number": "301-845-6336",
            "fax_number": "240-578-4478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILEY",
        "first_name": "VIRGINIA",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-07",
        "last_updated": "2016-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D0063227",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "926580505",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "926580506",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GINGER",
            "last_name": "WILEY",
            "middle_name": "C",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Walkersville, MD

Sources for this page

Verify at the official NPI Registry.