Individual provider Active NPI

Victoria Magloire Wongk, MD

  • Pediatrics Physician
  • Louisville, KY
National Provider Identifier
1447749544
Registry record updated Jul 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
100451 Issued in GA
Practice address
231 E Chestnut St
Louisville, KY 40202-1821
Phone
(502) 629-6000
Fax
(502) 852-8556
NPI assigned
May 3, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X 100451 GA Primary
Pediatrics Physician 208000000X 55225 KY

Addresses

Primary practice location

231 E Chestnut St
Louisville, KY 40202-1821

Mailing address

PO Box 776879
Chicago, IL 60677-6351
Phone (502) 588-9490

Other names 1

  • Victoria Shulami Magloire Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, GA2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20211101001999 KY Practitioner - Pediatric Medicine 4183012750 Reassigns benefits to 1 organization
I20250107000260 GA Practitioner - Emergency MedicinePractitioner - Pediatric Medicine 4183012750 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
100451GAMDPediatrics Physician
55225KYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Medical Care Foundation Inc CurrentSince Sep 18, 2024 Accepting new patients
Norton Children'S Medical Group, LLC Current Accepting new patients
Emory Medical Care Foundation Inc Current Accepting new patients
Norton Children'S Medical Group, LLC Pediatrics CurrentSince Dec 1, 2021 Accepting new patients
Emory Medical Care Foundation Inc Pediatrics CurrentSince Sep 18, 2024 Accepting new patients
Norton Children'S Medical Group, LLC CurrentSince Dec 1, 2021 Accepting new patients

Locations

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

2201 Henderson Mill Rd NE
Ste 160
Atlanta, GA 30345
Phone (404) 251-2193

4910 Chamberlain Ln
Louisville, KY 40241
Phone (502) 446-5000

601 S Floyd St
Ste 604
Louisville, KY 40202
Phone (502) 559-1670

231 E Chestnut St
Louisville, KY 40202
Phone (502) 852-8500

Organizations & group practices 6

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": "1525305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1447749544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776879",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776351",
            "telephone_number": "502-588-9490",
            "fax_number": "502-272-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 E CHESTNUT ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021821",
            "telephone_number": "502-629-6000",
            "fax_number": "502-852-8556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONGK",
        "first_name": "VICTORIA",
        "middle_name": "MAGLOIRE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-03",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "100451",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "55225",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VICTORIA",
            "last_name": "MAGLOIRE",
            "middle_name": "SHULAMI",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.