NPIMap

Individual provider Active NPI

Stephen Irwin Wagner, M.D.

  • Obstetrics & Gynecology Physician
  • Brandon, FL
National Provider Identifier
1023009461
Registry record updated Feb 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
ME15542 Issued in FL
Practice address
401 Oakfield Dr
Brandon, FL 33511-5710
Phone
(813) 654-2273
Fax
(813) 654-1384
NPI assigned
Nov 3, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X ME15542 FL Primary

Addresses

Primary practice location

401 Oakfield Dr
Brandon, FL 33511-5710

Mailing address

505 Oakfield Dr
Brandon, FL 33511-5700
Phone (813) 654-2273

Other identifiers 1

IdentifierTypeStateIssuer
057050800MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Healthpoint Medical Group Inc Obstetrics & Gynecology Past Accepting new patients
Exodus Women'S Center, Inc. Obstetrics & Gynecology Past Accepting new patients
Exodus Women'S Center, Inc. Obstetrics & Gynecology Past Accepting new patients
Exodus Women'S Center, Inc. Obstetrics & Gynecology Past Accepting new patients
Exodus Women'S Center, Inc. Obstetrics & Gynecology Past Accepting new patients
Exodus Women'S Center, Inc. Obstetrics & Gynecology Past Accepting new patients
Exodus Women'S Center, Inc. Obstetrics & Gynecology Past Accepting new patients
Exodus Women'S Center, Inc. Obstetrics & Gynecology Past Accepting new patients
Exodus Women'S Center, Inc. Obstetrics & Gynecology Past Accepting new patients
Exodus Women'S Center, Inc. Obstetrics & Gynecology Past Accepting new patients

Organizations & group practices 10

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": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454976000000",
    "number": "1023009461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 OAKFIELD DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115700",
            "telephone_number": "813-654-2273",
            "fax_number": "813-654-1384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 OAKFIELD DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115710",
            "telephone_number": "813-654-2273",
            "fax_number": "813-654-1384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "STEPHEN",
        "middle_name": "IRWIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-03",
        "last_updated": "2016-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME15542",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "057050800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.