NPIMap

Individual provider Active NPI

Andrea Mi Wild-Gingeleski

  • Nurse Practitioner
  • Bedford, VA
National Provider Identifier
1447923719
Registry record updated Feb 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
0024181709 Issued in VA
Practice address
582 Blue Ridge Ave
Bedford, VA 24523-2604
Phone
(434) 455-2480
NPI assigned
Jul 31, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 0024181709 VA Primary

Addresses

Primary practice location

582 Blue Ridge Ave
Bedford, VA 24523-2604

Mailing address

134 Elon Rd
Madison Heights, VA 24572-2536
Phone (434) 455-2480

Other practice location 1

705 Clearview Dr
Vinton, VA 24179-3605
Phone (540) 982-6691

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210817003679 VA Practitioner - Nurse Practitioner 0446655286 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Johnson Health CenterGroup PAC ID 9537060413, shared by 5 NPIs, 39 clinicians

Practice addresses (Care Compare)

582 Blue Ridge Ave
Bedford, VA 24523-2604
Phone (540) 425-7910

925 Village Hwy
Rustburg, VA 24588-4591
Phone (434) 528-0005

Hospital & facility affiliations

  • Centra Bedford Memorial Hospital Hospital, Bedford, VA, CCN 490088
  • Centra Health - Lynchburg Gen Hospital Hospital, Lynchburg, VA, CCN 490021

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Johnson Health Center CurrentSince Sep 12, 2022 Accepting new patients
Johnson Health Center Current Accepting new patients
Consonant Healing Medical Associates Nurse Practitioner CurrentSince Aug 11, 2021 Accepting new patients
Universal Health Corporation CurrentSince Dec 6, 2021 Accepting new patients
Johnson Health Center CurrentSince Sep 12, 2022 Accepting new patients
Johnson Health Center CurrentSince Sep 12, 2022 Accepting new patients
Johnson Health Center Past Accepting new patients

Locations

909 Ridgebrook Rd
Ste 300
Sparks Glencoe, MD 21152
Phone (443) 483-9300

320 Federal St
Lynchburg, VA 24504
Phone (434) 947-5967

109 Clearview Rd
Madison Heights, VA 24572
Phone (434) 929-1400

134 Elon Rd
Madison Hts, VA 24572
Phone (434) 929-1400

3900 Westerre Pkwy
Ste 300
Richmond, VA 23233
Phone (301) 928-5012

925 Village Hwy
Rustburg, VA 24588
Phone (434) 332-7367

1945 Roanoke Blvd
Salem, VA 24153
Phone (540) 345-3094

705 Clearview Dr
Vinton, VA 24179
Phone (540) 482-6691

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 7

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 8

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

NPI Registry JSON

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

{
    "created_epoch": "1627689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709164800000",
    "number": "1447923719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 ELON RD",
            "city": "MADISON HEIGHTS",
            "state": "VA",
            "postal_code": "245722536",
            "telephone_number": "434-455-2480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "582 BLUE RIDGE AVE",
            "city": "BEDFORD",
            "state": "VA",
            "postal_code": "245232604",
            "telephone_number": "434-455-2480"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "705 Clearview Dr",
            "address_purpose": "LOCATION",
            "city": "Vinton",
            "state": "VA",
            "postal_code": "241793605",
            "country_code": "US",
            "telephone_number": "540-982-6691",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILD-GINGELESKI",
        "first_name": "ANDREA",
        "middle_name": "MI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-31",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024181709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bedford, VA

Sources for this page

Verify at the official NPI Registry.