NPIMap

Organization Active NPI

St. Mary'S Health Wagon

  • Rural Health Clinic/Center
  • Clintwood, VA
National Provider Identifier
1487818902
Registry record updated Apr 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
0024128995 Issued in VA
Legal business name
ST. MARY'S HEALTH WAGON
Practice address
233 Chase St.
Clintwood, VA 24228
Phone
(276) 926-2254
NPI assigned
Jul 14, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2019

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

Authorized official

Name
Mrs. Paula Meade
Title
Clinical Director
Phone
(276) 328-8850

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 0024128995 VA Primary

Addresses

Primary practice location

233 Chase St.
Clintwood, VA 24228

Mailing address

233 Chase St.
Clintwood, VA 24228
Phone (276) 926-2254

Other names 1

  • The Health Wagon Doing business as

National Provider Directory

National Provider Directory
Tax ID family
St Mary'S Health Wagon Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1215993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555286400000",
    "number": "1487818902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 CHASE ST.",
            "city": "CLINTWOOD",
            "state": "VA",
            "postal_code": "24228",
            "telephone_number": "276-926-2254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 CHASE ST.",
            "city": "CLINTWOOD",
            "state": "VA",
            "postal_code": "24228",
            "telephone_number": "276-926-2254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. MARY'S HEALTH WAGON",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-14",
        "last_updated": "2019-04-15",
        "status": "A",
        "authorized_official_last_name": "MEADE",
        "authorized_official_first_name": "PAULA",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "276-328-8850",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "VA",
            "license": "0024128995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Health Wagon",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clintwood, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.