Active NPI
Melissa Wagner, RDMS
- Sonography Radiologic Technologist
- Salem, VA
National Provider Identifier
1063820710
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sonography Radiologic Technologist
- License
- 153306
- Practice address
- 1970 Roanoke Blvd
Salem, VA 24153-6404 - Phone
- (651) 335-4919
- NPI assigned
- Jul 25, 2014
- Last updated
- Jul 25, 2014
- 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 |
|---|---|---|---|---|
| Sonography Radiologic Technologist | 2471S1302X | 153306 | VA | Primary |
Addresses
Primary practice location
1970 Roanoke Blvd
Salem, VA 24153-6404
Mailing address
1970 Roanoke Blvd
Salem, VA 24153-6404
Phone (651) 335-4919
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 153306 | VA | MD | Sonography Radiologic Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1406246400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1406246400000",
"number": "1063820710",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1970 ROANOKE BLVD",
"city": "SALEM",
"state": "VA",
"postal_code": "241536404",
"telephone_number": "651-335-4919"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1970 ROANOKE BLVD",
"city": "SALEM",
"state": "VA",
"postal_code": "241536404",
"telephone_number": "651-335-4919"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGNER",
"first_name": "MELISSA",
"credential": "RDMS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-07-25",
"last_updated": "2014-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "2471S1302X",
"taxonomy_group": "",
"desc": "Radiologic Technologist, Sonography",
"state": "VA",
"license": "153306",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Salem, VA
- Stephanie Nicole Vlahos, D.D.S.
- Donald Burgess Vogelsong, BS, RBT
- Neeta Vorst, FNP
- Sarah Christine Voss Horrell, PH.D.
- Kathryn Joyce Vuich, R.PH.
- Kristin Wahlberg-Painter
- Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-1309)
- Wal-Mart Stores East, LP (Vision Center 30-1309)
- Preston Adam Waldrop, M.D.
- Walgreen Co (Walgreens #07604)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.