Individual provider Active NPI

Laurie A Wilmoth, FNP

  • Family Nurse Practitioner
  • Danville, VA
National Provider Identifier
1902850902
Registry record updated Nov 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024055870 Issued in VA
Practice address
1040 Main St
Danville, VA 24541-1816
Phone
(434) 792-1433
Fax
(434) 797-2807
NPI assigned
May 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024055870 VA Primary

Addresses

Primary practice location

1040 Main St
Danville, VA 24541-1816

Mailing address

1040 Main St
PO Box 1360
Danville, VA 24541-1816
Phone (434) 792-1433

Other identifiers 1

IdentifierTypeStateIssuer
010115477MedicaidVA

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
I20050119001041 VA Practitioner - Nurse Practitioner 9234188970

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024055870VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Danville Emergency Physicians, PC Past Accepting new patients
Emergency Physicians of Southern Virginia LLP Past Accepting new patients
Piedmont Day Surgery Center Inc Past Accepting new patients

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": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289260800000",
    "number": "1902850902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 MAIN ST",
            "address_2": "PO BOX 1360",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245411816",
            "telephone_number": "434-792-1433",
            "fax_number": "434-797-2807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 MAIN ST",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245411816",
            "telephone_number": "434-792-1433",
            "fax_number": "434-797-2807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILMOTH",
        "first_name": "LAURIE",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-22",
        "last_updated": "2010-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024055870",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010115477",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, VA

Sources for this page

Verify at the official NPI Registry.