St. Mary's Health Wagon

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

ST. MARY'S HEALTH WAGON

Practice address

5626 Patriot Drive
Wise, VA 24293-7070

Phone

(276) 328-8850

Fax

(276) 328-8853

NPI assigned

Nov 2, 2013

Last updated

Nov 2, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Teresa L. Gardner, D.N.P.

Title

Executive Director

Phone

(276) 328-8850

Specialties & licenses 1

Addresses

Other names 1

• The Health Wagon Other name

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tauna Gulley, PHD, FNP, MSN

  • Psychiatric/Mental Health Nurse Practitioner
  • Richlands, VA
  • NPI 1477951515
  NPD (past)
• Paula Hill-Collins, NP

  • Family Nurse Practitioner
  • Wise, VA
  • NPI 1619948486
  NPD (past)

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

{
    "created_epoch": "1383350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383350400000",
    "number": "1114356037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5626 PATRIOT DRIVE",
            "city": "WISE",
            "state": "VA",
            "postal_code": "242937070",
            "telephone_number": "276-328-8850",
            "fax_number": "276-328-8853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5626 PATRIOT DRIVE",
            "city": "WISE",
            "state": "VA",
            "postal_code": "242937070",
            "telephone_number": "276-328-8850",
            "fax_number": "276-328-8853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. MARY'S HEALTH WAGON",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-02",
        "last_updated": "2013-11-02",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "TERESA",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "276-328-8850",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "D.N.P."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Health Wagon",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Katie Scott, M.S. CCC-SLP
• Angela Stallard Short, FNP
• Dawn Short, FNP
• Dana Sibrel, MA, ATC
• St. Mary's Health Wagon
• St. Mary's Pharmacy (St. Mary's Health Wagon)
• Olivia Stallard, DMD
• Autumn Marie Starnes, D.O.
• Chritsopher T. Starnes, M.D.
• Stephanie Strouth, LPC

• Family Medicine Physician in Wise, VA
• Providers in Wise, VA by specialty
• Family Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.