NPIMap

Individual provider Active NPI

Anne Wilson Wagstaff, MD

  • Internal Medicine Physician
  • Fredericksburg, VA
National Provider Identifier
1942707435
Registry record updated Jun 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101274454 Issued in VA
Practice address
1201 Sam Perry Blvd Ste 280
Fredericksburg, VA 22401-8400
Phone
(407) 419-2005
NPI assigned
Apr 10, 2018
Last updated
Jun 28, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 38982 AL
Internal Medicine Physician 207R00000X 0101274454 VA Primary

Addresses

Primary practice location

1201 Sam Perry Blvd Ste 280
Fredericksburg, VA 22401-8400

Mailing address

625 19TH Street South
Birmingham, AL 35249

Other practice location 1

500 22nd Ave S
Birmingham, AL 35205-6430
Phone (205) 801-7440

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address annewagstaff@direct.uabmedicine.org Direct University of Alabama Hospital

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220727003112 VA Practitioner - Internal Medicine 8325393309 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University Alabama Birmingham - School of Optometry, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mary Washington Hospital IncGroup PAC ID 0446143820, 53 clinicians

Practice addresses (Care Compare)

1201 B Sam Perry Blvd
Suite 280
Fredericksburg, VA 22401-8457
Phone (540) 741-5502

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
38982ALMDInternal Medicine Physician
0101274454VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Washington Hospital, Inc. CurrentSince May 1, 2023 Accepting new patients
Mary Washington Hospital Inc. CurrentSince May 1, 2023 Accepting new patients

Locations

1001 Sam Perry Blvd
Fredericksburg, VA 22401
Phone (540) 741-1100

1201 Sam Perry Blvd
Ste 201
Fredericksburg, VA 22401
Phone (540) 741-1100

1201 Sam Perry Blvd
Ste 280
Fredericksburg, VA 22401
Phone (540) 361-2922

2300 Fall Hill Ave
Ste 317
Fredericksburg, VA 22401
Phone (540) 741-1041

Interoperability endpoints

  • Direct secure messaging: annewagstaff@direct.uabmedicine.org
  • Direct secure messaging: awagstaff95157@marywashingtonhealthcare.direct-ci.com

Organizations & group practices 2

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.

Hospital & facility affiliations 12

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": "1523318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1942707435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 19TH STREET SOUTH",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "35249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 SAM PERRY BLVD STE 280",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224018400",
            "telephone_number": "407-419-2005"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 22nd Ave S",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352056430",
            "country_code": "US",
            "telephone_number": "205-801-7440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAGSTAFF",
        "first_name": "ANNE",
        "middle_name": "WILSON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-10",
        "last_updated": "2023-06-28",
        "certification_date": "2023-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "38982",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101274454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "annewagstaff@direct.uabmedicine.org",
            "affiliation": "Y",
            "affiliationName": "University of Alabama Hospital",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "500 22nd Ave S",
            "city": "Birmingham",
            "state": "AL",
            "country_code": "US",
            "postal_code": "352056430",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

Verify at the official NPI Registry.