Individual provider Active NPI

Mary L Wolf, NP

  • Nurse Practitioner
  • Louisa, VA
National Provider Identifier
1851379028
Registry record updated Oct 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
0024134693 Issued in VA
Practice address
115 Jefferson Hwy
Suite 9
Louisa, VA 23093-6563
Phone
(540) 967-9401
Fax
(540) 967-9405
NPI assigned
Jan 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2012

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 0024134693 VA Primary

Addresses

Primary practice location

115 Jefferson Hwy
Suite 9
Louisa, VA 23093-6563

Mailing address

115 Jefferson Hwy
Suite 9
Louisa, VA 23093-6563
Phone (540) 967-9401

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100804001046 VA Practitioner - Nurse Practitioner 5092848507 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024134693VAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Central Virginia Health Services Inc CurrentSince Apr 26, 2010 Accepting new patients
Central Virginia Health Services Inc Current Accepting new patients
Central Virginia Health Services Inc CurrentSince Apr 26, 2010 Accepting new patients

Locations

115 Jefferson Hwy
Ste 9
Louisa, VA 23093
Phone (540) 967-9401

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1136505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351555200000",
    "number": "1851379028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 JEFFERSON HWY",
            "address_2": "SUITE 9",
            "city": "LOUISA",
            "state": "VA",
            "postal_code": "230936563",
            "telephone_number": "540-967-9401",
            "fax_number": "540-967-9405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 JEFFERSON HWY",
            "address_2": "SUITE 9",
            "city": "LOUISA",
            "state": "VA",
            "postal_code": "230936563",
            "telephone_number": "540-967-9401",
            "fax_number": "540-967-9405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLF",
        "first_name": "MARY",
        "middle_name": "L",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-06",
        "last_updated": "2012-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024134693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisa, VA

Sources for this page

Verify at the official NPI Registry.