NPIMap

Individual provider Active NPI

Barbara Joyce Wagnon, NP-C

  • Family Nurse Practitioner
  • Roanoke, VA
National Provider Identifier
1104397702
Registry record updated Aug 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024177032 Issued in VA
Practice address
2001 Crystal Spring Ave SW Ste 302
Roanoke, VA 24014-2465
Phone
(540) 981-7653
NPI assigned
Dec 8, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0024177032 VA
Family Nurse Practitioner 363LF0000X 0024177032 VA Primary

Addresses

Primary practice location

2001 Crystal Spring Ave SW Ste 302
Roanoke, VA 24014-2465

Mailing address

213 S Jefferson St Ste 1006
Roanoke, VA 24011-1713

Other identifiers 1

IdentifierTypeStateIssuer
0024177032OtherVANURSE PRACTITIONER LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bwagnon5813@direct.carilionclinic.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191213000002 VA Practitioner - Nurse Practitioner 6305279803 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carilion Medical CenterGroup PAC ID 9830096585, 956 clinicians

Practice addresses (Care Compare)

2001 Crystal Spring Ave SW
Suite 302
Roanoke, VA 24014-2465
Phone (540) 981-7859

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0024177032VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carilion Giles Community Hospital CurrentSince May 29, 2025 Accepting new patients
Carilion Medical Center CurrentSince Dec 22, 2019 Accepting new patients
Carilion Giles Community Hospital CurrentSince May 29, 2025 Accepting new patients
Carilion Medical Center CurrentSince Dec 22, 2019 Accepting new patients

Locations

159 Hartley Way
Pearisburg, VA 24134
Phone (540) 921-6000

213 S Jefferson St
Ste 1006
Roanoke, VA 24011
Phone (540) 224-5353

2001 Crystal Spring Ave SW
Ste 302
Roanoke, VA 24014
Phone (540) 981-7653

2017 Jefferson St SW
Roanoke, VA 24014
Phone (540) 981-7128

Organizations & group practices 4

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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1544227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1104397702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 S JEFFERSON ST STE 1006",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240111713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 CRYSTAL SPRING AVE SW STE 302",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240142465",
            "telephone_number": "540-981-7653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNON",
        "first_name": "BARBARA",
        "middle_name": "JOYCE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-08",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0024177032",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024177032",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER LICENSE",
            "identifier": "0024177032",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bwagnon5813@direct.carilionclinic.org",
            "affiliation": "N",
            "endpointDescription": "bwagnon5813@direct.carilionclinic.org",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2001 Crystal Spring Ave SW Ste 302",
            "city": "Roanoke",
            "state": "VA",
            "country_code": "US",
            "postal_code": "240142465",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.