Individual provider Active NPI

Michael L Gwaltney, MD

  • Pediatrics Physician
  • Fishersville, VA
National Provider Identifier
1386802015
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
0101249737 Issued in VA
Practice address
78 Medical Center Dr
Fishersville, VA 22939-2332
Phone
(540) 932-4075
Fax
(540) 932-5199
NPI assigned
May 29, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 0101249737 VA Primary

Addresses

Primary practice location

78 Medical Center Dr
Fishersville, VA 22939-2332

Mailing address

PO Box 388
Fishersville, VA 22939-0388
Phone (540) 932-5162

Other practice location 1

1840 Amherst St
Winchester, VA 22601-2808
Phone (540) 536-8000

Other practice location 2

57 Beam Ln Ste 202
Fishersville, VA 22939-2350
Phone (540) 332-5373

Other practice location 3

3300 Gallows Rd
Falls Church, VA 22042-3300
Phone (703) 776-4001

Other practice location 4

1840 Amherst St
Winchester, VA 22601-2808
Phone (540) 536-8000

Other practice location 5

1215 Lee St
Charlottesville, VA 22908-2332
Phone (434) 924-5321

Other practice location 6

1204 W Main St
Charlottesville, VA 22903-2824
Phone (434) 924-5321

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mgwaltney678290@soc.inova.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, MD, DC3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20110916000372 VA Practitioner - Pediatric MedicinePractitioner - Hospitalist 7315118601 Reassigns benefits to 4 organizations
I20180919000603 MD Practitioner - HospitalistPractitioner - Pediatric Medicine 7315118601 Reassigns benefits to 1 organization
I20200401003458 DC Practitioner - HospitalistPractitioner - Pediatric Medicine 7315118601 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101249737VAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Winchester Medical Center Current Accepting new patients
Inova Health Care Services Pediatrics CurrentSince Mar 23, 2020 Accepting new patients
Inova Health Care Services CurrentSince Mar 23, 2020 Accepting new patients
Winchester Medical Center CurrentSince Mar 24, 2020 Accepting new patients
Mdics at Calvert LLC CurrentSince Mar 25, 2019 Accepting new patients
Adfinitas Health at Fauquier, LLC CurrentSince Dec 10, 2019 Accepting new patients
Winchester Medical Center Pediatrics CurrentSince Mar 24, 2020 Accepting new patients
Inova Health Care Services CurrentSince Mar 23, 2020 Accepting new patients
Winchester Medical Center Past Accepting new patients

Locations

7250 Parkway Dr
Ste 500
Hanover, MD 21076
Phone (410) 999-1130

100 Hospital Rd
Prnc Frederck, MD 20678
Phone (410) 414-4791

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

224B Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894

500 Hospital Dr
Warrenton, VA 20186
Phone (540) 316-5000

1840 Amherst St
Winchester, VA 22601
Phone (540) 536-8700

Interoperability endpoints

  • Direct secure messaging: mgwaltney146873@direct.healthsystem.virginia.edu

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1212019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1386802015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 388",
            "city": "FISHERSVILLE",
            "state": "VA",
            "postal_code": "229390388",
            "telephone_number": "540-932-5162",
            "fax_number": "540-932-5875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "78 MEDICAL CENTER DR",
            "city": "FISHERSVILLE",
            "state": "VA",
            "postal_code": "229392332",
            "telephone_number": "540-932-4075",
            "fax_number": "540-932-5199"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1840 Amherst St",
            "address_purpose": "LOCATION",
            "city": "Winchester",
            "state": "VA",
            "postal_code": "226012808",
            "country_code": "US",
            "telephone_number": "540-536-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "57 Beam Ln Ste 202",
            "address_purpose": "LOCATION",
            "city": "Fishersville",
            "state": "VA",
            "postal_code": "229392350",
            "country_code": "US",
            "telephone_number": "540-332-5373",
            "fax_number": "540-932-5382",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3300 Gallows Rd",
            "address_purpose": "LOCATION",
            "city": "Falls Church",
            "state": "VA",
            "postal_code": "220423300",
            "country_code": "US",
            "telephone_number": "703-776-4001",
            "fax_number": "703-776-7113",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1840 Amherst St",
            "address_purpose": "LOCATION",
            "city": "Winchester",
            "state": "VA",
            "postal_code": "226012808",
            "country_code": "US",
            "telephone_number": "540-536-8000",
            "fax_number": "540-836-3286",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1215 Lee St",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229082332",
            "country_code": "US",
            "telephone_number": "434-924-5321",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1204 W Main St",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229032824",
            "country_code": "US",
            "telephone_number": "434-924-5321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GWALTNEY",
        "first_name": "MICHAEL",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-29",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101249737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mgwaltney678290@soc.inova.org",
            "affiliation": "N",
            "address_1": "1840 Amherst St",
            "city": "Winchester",
            "state": "VA",
            "country_code": "US",
            "postal_code": "226012808",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fishersville, VA

Sources for this page

Verify at the official NPI Registry.