NPIMap

Individual provider Active NPI

Valory Elizabeth Wangler, MD

  • Family Medicine Physician
  • Zuni, NM
National Provider Identifier
1457579963
Registry record updated Sep 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ML20008715 Issued in WA
Practice address
21 B Ave
Zuni, NM 87327
Phone
(206) 861-5767
NPI assigned
Apr 22, 2007
Last updated
Sep 22, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ML20008715 WA Primary

Addresses

Primary practice location

21 B Ave
Zuni, NM 87327

Mailing address

PO Box 467
Zuni, NM 87327-0467
Phone (206) 861-5767

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, NM2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20101102000328 TX Practitioner - Family Practice 8022178698 Reassigns benefits to 1 organization
I20170918000105 NM Practitioner - Family Practice 8022178698 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Baylor College of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gallup Community HealthGroup PAC ID 3375926975, 13 clinicians

Practice addresses (Care Compare)

2111 College Dr
Gallup, NM 87301-5600
Phone (505) 397-5172

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ML20008715WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gallup Community Health Family Medicine CurrentSince Jul 1, 2022 Accepting new patients
Zuni Indian Hospital CurrentSince Oct 18, 2010 Accepting new patients
GCH Campus Clinic Current Accepting new patients
Rehoboth McKinley Christian Health Care Services, Inc Family Medicine CurrentSince Mar 22, 2018 Accepting new patients
Rehoboth McKinley Christian Health Care Services, Inc CurrentSince Mar 22, 2018 Accepting new patients
Rehoboth McKinley Christian Health Care Services, Inc. Current Accepting new patients

Locations

1900 Red Rock Dr
Gallup, NM 87301
Phone (505) 863-1820

1901 Red Rock Dr
Gallup, NM 87301
Phone (505) 726-6875

2022 E Aztec Ave
Gallup, NM 87301
Phone (505) 397-5172

2111 College Dr
Gallup, NM 87301
Phone (505) 397-5172

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FBBICD

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Gallup Community HealthGallup, NM, CCN 321003 Federally qualified health center Corporate Officer
W-2 Managing Employee		 Jul 1, 2022
Jul 5, 2022

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1177200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316649600000",
    "number": "1457579963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 467",
            "city": "ZUNI",
            "state": "NM",
            "postal_code": "873270467",
            "telephone_number": "206-861-5767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 B AVE",
            "city": "ZUNI",
            "state": "NM",
            "postal_code": "87327",
            "telephone_number": "206-861-5767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANGLER",
        "first_name": "VALORY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-22",
        "last_updated": "2011-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "ML20008715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Zuni, NM

Sources for this page

Verify at the official NPI Registry.