Mary Lanier Huntley-Wagner, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0024168926 Issued in VA

Practice address

813 Independence Blvd
Virginia Beach, VA 23455-6004

Phone

(757) 333-7625

NPI assigned

Aug 13, 2009

Last updated

Dec 2, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

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 1

Specialty

Nurse Practitioner

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tidewater Physicians Multispecialty Group, PCGroup PAC ID 2860398526, 259 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sentara Home Care Services-Virginia Beach Home health agency, Chesapeake, VA, CCN 497747
• Sentara Virginia Beach General Hospital Hospital, Virginia Beach, VA, CCN 490057
• Sentara Leigh Hospital Hospital, Norfolk, VA, CCN 490046
• Sentara Princess Anne Hospital Hospital, Virginia Beach, VA, CCN 490119
• Sentara Norfolk General Hospital Hospital, Norfolk, VA, CCN 490007

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BGFHDD

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.

• Tidewater Physicians Multispecialty Group PC

  • Family Medicine Physician
  • Newport News, VA
  • NPI 1902848294
  Medicare reassignment Care Compare group NPD
• Privia Medical Group, LLC

  • Internal Medicine Physician
  • Arlington, VA
  • NPI 1013042480
  Medicare reassignment NPD
• Tidewater Physicians Multispecialty Group PC

  • Ambulatory Surgical Clinic/Center
  • Williamsburg, VA
  • NPI 1316790512
  NPD
• Privia Medical Group, LLC

  • Pain Medicine (Psychiatry & Neurology) Physician
  • Rockville, MD
  • NPI 1811715436
  NPD
• The Eye Specialists LTD

  • Ophthalmology Physician
  • Virginia Beach, VA
  • NPI 1720179104
  NPD (past)

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

• Sentara Enterprises

  • Home Health Agency
  • Chesapeake, VA
  • NPI 1710425152
  Care Compare affiliation
• Sentara Hospitals

  dba Sentara Nightingale

  • Air Ambulance
  • Norfolk, VA
  • NPI 1235205147

  Hospital

  Care Compare affiliation
• Sentara Hospitals

  dba Sentara Norfolk General Hospital

  • General Acute Care Hospital
  • Norfolk, VA
  • NPI 1437119310
  Care Compare affiliation
• Sentara Hospitals

  dba Sentara Virginia Beach General Hospital

  • General Acute Care Hospital
  • Virginia Beach, VA
  • NPI 1629038336
  Care Compare affiliation
• Sentara Hospitals

  dba Sentara Leigh Hospital

  • General Acute Care Hospital
  • Norfolk, VA
  • NPI 1811957681
  Care Compare affiliation
• Sentara Princess Anne Hospital

  • General Acute Care Hospital
  • Virginia Beach, VA
  • NPI 1528028396
  Care Compare affiliation

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

{
    "created_epoch": "1250121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575244800000",
    "number": "1376775098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 OMNI BLVD STE 101",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064430",
            "telephone_number": "757-232-8769",
            "fax_number": "757-232-8875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "813 INDEPENDENCE BLVD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234556004",
            "telephone_number": "757-333-7625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUNTLEY-WAGNER",
        "first_name": "MARY",
        "middle_name": "LANIER",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-13",
        "last_updated": "2019-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024168926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Hunter
• Thomas Ryan Hunter, P.A.
• Traci Hunter, LCSW
• Rasean Huntergreene, PTA
• Patricia Huntington
• Michael S Hurban, M.D.
• Alicia Michelle Hurdle, L.M.F.T., L.P.C.,
• Carly Grace Hurdle, BCBA
• Ashanti Ruth Hurling
• Taylor M Hurrinus, PT

• Family Nurse Practitioner in Virginia Beach, VA
• Providers in Virginia Beach, 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 2, 2019; 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.