Wagoner Family Eye Care, PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

0618002121 Issued in VA

Legal business name

WAGONER FAMILY EYE CARE, PLLC

Practice address

3701 Old Forest Rd
Suite B
Lynchburg, VA 24501-6901

Phone

(434) 385-0213

Fax

(434) 385-0214

NPI assigned

Jul 24, 2012

Last updated

Jul 24, 2012By 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

Dr. Robert L Wagoner, O.D.NPI 1568551265

Title

President

Phone

(434) 385-0213

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

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.

• Robert Luke Wagoner, O. D.

  • Optometrist
  • Dover, DE
  • NPI 1568551265

  VA

  Medicare reassignment NPD Authorized official
• Elizabeth Mason Darby, O.D.

  • Optometrist
  • Tupelo, MS
  • NPI 1902875602
  NPD (past)

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

{
    "created_epoch": "1343088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343088000000",
    "number": "1376899625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3701 OLD FOREST RD",
            "address_2": "SUITE B",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245016901",
            "telephone_number": "434-385-0213",
            "fax_number": "434-385-0214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 OLD FOREST RD",
            "address_2": "SUITE B",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245016901",
            "telephone_number": "434-385-0213",
            "fax_number": "434-385-0214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAGONER FAMILY EYE CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-24",
        "last_updated": "2012-07-24",
        "status": "A",
        "authorized_official_last_name": "WAGONER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "434-385-0213",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618002121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Scott Wade, MD
• Kayla Wade
• Tonya Lynnell Wade
• Brandon Waggoner, LPC
• Laura Elizabeth Wagner, PH.D.
• Kimberly Wakil
• Wal-Mart Stores East LP (WalMart Pharmacy 10-4697)
• Wal-Mart Stores East LP (Vision Center 30-4697)
• Wal-Mart Stores East LP (Walmart Pharmacy 10-3605)
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-1350)

• Optometrist in Lynchburg, VA
• Providers in Lynchburg, VA by specialty
• Optometrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.