Laura Virgo, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

35.139781 Issued in OH

Practice address

4881 Sugar Maple Drive
Office Symbol: SGXW
Wright-Patterson AFB, OH 45433

Phone

(937) 775-7792

NPI assigned

Apr 12, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1523491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656806400000",
    "number": "1669979944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4881 SUGAR MAPLE DRIVE",
            "address_2": "OFFICE SYMBOL: SGXW",
            "city": "WRIGHT-PATTERSON AFB",
            "state": "OH",
            "postal_code": "45433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4881 SUGAR MAPLE DRIVE",
            "address_2": "OFFICE SYMBOL: SGXW",
            "city": "WRIGHT-PATTERSON AFB",
            "state": "OH",
            "postal_code": "45433",
            "telephone_number": "937-775-7792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIRGO",
        "first_name": "LAURA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-12",
        "last_updated": "2022-07-03",
        "certification_date": "2022-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35.139781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Isaac Vance, DMD
• Patrick Vancura
• Anthony Vande Hei, DO
• Daniel Lee Vansyoc, MD
• Thomas Vaughn, PA-C
• Jacqueline Kate Wade, M.D.
• Elmer F Wahl, MD
• William Graham Wall, LICSW, BCD
• Pamela Phyllis Ward-Demo, MD, DVM
• Alan Ward

• Psychiatry Physician in Wright Patterson AFB, OH
• Providers in Wright Patterson AFB, OH by specialty
• Psychiatry Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.