NPIMap

Individual provider Active NPI

Brian Wittmus Zagol, MD

  • Interventional Cardiology Physician
  • Danville, VA
National Provider Identifier
1902901556
Registry record updated Nov 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
0101234822 Issued in VA
Practice address
158 Executive Dr
Danville, VA 24541-4100
Phone
(434) 791-1088
Fax
(434) 799-8525
NPI assigned
Sep 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 0101234822 VA
Cardiovascular Disease Physician 207RC0000X 39369 TN
Student in an Organized Health Care Education/Training Program 390200000X VA
Interventional Cardiology Physician 207RI0011X 0101234822 VA Primary

Addresses

Primary practice location

158 Executive Dr
Danville, VA 24541-4100

Mailing address

201 S Main St Ste 1100
Danville, VA 24541-2938
Phone (434) 791-1088

Other identifiers 2

IdentifierTypeStateIssuer
3337419MedicaidTN
4121983OtherTNBLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, NC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110912000501 VA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 9436168622 Reassigns benefits to 1 organization
I20161004001351 NC Practitioner - Cardiovascular Disease (Cardiology) 9436168622 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Temple University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Danville Physician Practices LLCGroup PAC ID 4688606304, 171 clinicians

Practice addresses (Care Compare)

201 S Main St
Suite 1100
Danville, VA 24541-2938
Phone (434) 791-3009

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting11
Varicose vein removal18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
39369TNMDCardiovascular Disease Physician
0101234822VAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Danville Physician Practices LLC CurrentSince Feb 6, 2016 Accepting new patients
Danville Physician Practices LLC Cardiovascular Disease CurrentSince Feb 6, 2016 Accepting new patients
Two Rivers Physician Practices, LLC CurrentSince Jul 9, 2016 Accepting new patients
Greensboro Pathology, LLC Current Accepting new patients

Locations

201 S Main St
Danville, VA 24541
Phone (434) 791-3009

201 S Main St
Ste 1100
Danville, VA 24541
Phone (434) 791-3009

142 S Main St
Danville, VA 24541
Phone (434) 799-2100

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19847/brand/3/csg/21/fhir/r4
  • Direct secure messaging: brian.zagol.1@19847.direct.athenahealth.com
  • Direct secure messaging: bzagol240908@direct.medicine.duke.edu

Organizations & group practices 4

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667692800000",
    "number": "1902901556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 S MAIN ST STE 1100",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245412938",
            "telephone_number": "434-791-1088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "158 EXECUTIVE DR",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245414100",
            "telephone_number": "434-791-1088",
            "fax_number": "434-799-8525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAGOL",
        "first_name": "BRIAN",
        "middle_name": "WITTMUS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2022-11-06",
        "certification_date": "2022-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "VA",
            "license": "0101234822",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TN",
            "license": "39369",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "VA",
            "license": "0101234822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3337419",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "4121983",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, VA

Sources for this page

Verify at the official NPI Registry.