Melissa Dalton Wagner, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0024184994 Issued in VA

Practice address

34 Medical Park Blvd
Petersburg, VA 23805-9283

Phone

(804) 609-0175

Fax

(804) 835-5999

NPI assigned

Sep 17, 2015

Last updated

Dec 3, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in KY, VA, OH3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 3

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Spero Health of Virginia LLCGroup PAC ID 5193102788, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Spero Health of Virginia, LLC

  • Addiction Medicine (Family Medicine) Physician
  • Martinsville, VA
  • NPI 1104465103
  Medicare reassignment Care Compare group NPD
• Albaree Health Services LLC

  • Internal Medicine Physician
  • Salyersville, KY
  • NPI 1730232182
  Medicare reassignment NPD
• Eastern Kentucky Tender Care Pediatrics LLC

  • Rural Health Clinic/Center
  • Prestonsburg, KY
  • NPI 1043437254
  Medicare reassignment NPD
• Frontier Behavioral Health Center PLLC

  • Multi-Specialty Clinic/Center
  • Salyersville, KY
  • NPI 1295287118
  Medicare reassignment NPD
• Frontier Medical Associates of Paintsville Inc

  • Rural Health Clinic/Center
  • Paintsville, KY
  • NPI 1568070142

  Family

  Medicare reassignment NPD
• Spero Health of Kentucky, LLC

  • Addiction Medicine (Family Medicine) Physician
  • Danville, KY
  • NPI 1982102109
  Medicare reassignment NPD
• Spero Health of Ohio, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Zanesville, OH
  • NPI 1346748563
  Medicare reassignment NPD
• Samaritan Family Care LLC

  • Family Medicine Physician
  • Paintsville, KY
  • NPI 1629536206
  NPD

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

{
    "created_epoch": "1442448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764720000000",
    "number": "1174992382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 MEDICAL PARK BLVD",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238059283",
            "telephone_number": "804-609-0175",
            "fax_number": "804-835-5999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 MEDICAL PARK BLVD",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238059283",
            "telephone_number": "804-609-0175",
            "fax_number": "804-835-5999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "MELISSA",
        "middle_name": "DALTON",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-17",
        "last_updated": "2025-12-03",
        "certification_date": "2025-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024184994",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3009798",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN LICENSE NUMBER",
            "identifier": "3009798",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100385910",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AANP CERTIFICATION NUMBER",
            "identifier": "F0915844",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Visions Family Services, Inc.
• William Roger Visser, MD
• Vista Park Memory Care Center, LLC (Vista Park Memory Care Center)
• VMG Specialists PC
• Carissa Vukmer, PA-C
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-2160)
• Wal-Mart Stores East, LP (Vision Center 30-2160)
• Walgreen Co (Walgreens #09270)
• Ebony Glynn Walker, LPC
• Alexandria Wall, LCSW

• Family Nurse Practitioner in Petersburg, VA
• Providers in Petersburg, VA by specialty
• Family Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2025; 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.