Individual provider Active NPI

John E Wing, M.D.

  • Internal Medicine Physician
  • Suffolk, VA
National Provider Identifier
1841343126
Registry record updated Mar 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101047369 Issued in VA
Practice address
114 N Main St Ste 200
Suffolk, VA 23434-4564
Phone
(757) 934-1003
Fax
(757) 934-1660
NPI assigned
Jan 19, 2007
Last updated
Mar 18, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101047369 VA Primary

Addresses

Primary practice location

114 N Main St Ste 200
Suffolk, VA 23434-4564

Mailing address

114 N Main St Ste 200
Suffolk, VA 23434-4564
Phone (757) 934-1003

Other identifiers 3

IdentifierTypeStateIssuer
095436OtherVAANTHEM
6068286MedicaidVA
890658EMedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20151002001076 VA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 4284777400

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Suffolk Medical Center Internal Medicine Current Accepting new patients

Locations

114 N Main St
Ste 200
Suffolk, VA 23434
Phone (757) 934-1003

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268870400000",
    "number": "1841343126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 N MAIN ST STE 200",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234344564",
            "telephone_number": "757-934-1003",
            "fax_number": "757-934-1660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 N MAIN ST STE 200",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234344564",
            "telephone_number": "757-934-1003",
            "fax_number": "757-934-1660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WING",
        "first_name": "JOHN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-19",
        "last_updated": "2010-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101047369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "095436",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6068286",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890658E",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffolk, VA

Sources for this page

Verify at the official NPI Registry.