Individual provider Active NPI

Wanda Kay Delong

  • Family Nurse Practitioner
  • Galax, VA
National Provider Identifier
1407506512
Registry record updated Jul 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024183209 Issued in VA
Practice address
306 Meadow St
Galax, VA 24333-3020
Phone
(276) 236-5300
Fax
(276) 236-5303
NPI assigned
Mar 24, 2022
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oldtown Medical Care LLC 4 clinicians

Practice addresses (Care Compare)

306 Meadow St
Galax, VA 24333-3020
Phone (276) 236-5300

Hospital & facility affiliations

  • Twin County Regional Hospital Hospital, Galax, VA, CCN 490115

Merit-based Incentive Payment System (MIPS)

Final score
35.98 of 100Reported as group
Quality
0
Promoting interoperability
0
Improvement activities
20
Cost
78.28

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230302000285 VA Practitioner - Nurse Practitioner 7214300839 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0001200169VAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Oldtown Medical Care, LLC CurrentSince Jun 18, 2025 Accepting new patients
Galax Treatment Center, LLC PastSince Mar 1, 2022 Accepting new patients

Locations

306 Meadow St
Galax, VA 24333
Phone (276) 236-2300

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 0001200169 VA
Family Nurse Practitioner 363LF0000X 0024183209 VA Primary

Addresses

NPPES NPI Registry

Primary practice location

306 Meadow St
Galax, VA 24333-3020

Mailing address

306 Meadow St
Galax, VA 24333-3020
Phone (276) 236-5300

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 28, 2025.

{
    "created_epoch": "1648080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753660800000",
    "number": "1407506512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 MEADOW ST",
            "city": "GALAX",
            "state": "VA",
            "postal_code": "243333020",
            "telephone_number": "276-236-5300",
            "fax_number": "276-236-5303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 MEADOW ST",
            "city": "GALAX",
            "state": "VA",
            "postal_code": "243333020",
            "telephone_number": "276-236-5300",
            "fax_number": "276-236-5303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELONG",
        "first_name": "WANDA",
        "middle_name": "KAY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-24",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001200169",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024183209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Galax, VA

Sources for this page

Verify at the official NPI Registry.