Duke Elvin Wagner, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY298 Issued in HI

Practice address

970 N Kalaheo Ave
A204
Kailua, HI 96734-1801

Phone

(808) 254-5468

Fax

(808) 262-4437

NPI assigned

May 11, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Duke E. Wagner,PH.D.,Inc.

  • Psychologist
  • Kailua, HI
  • NPI 1356555791
  NPD (past) Authorized official

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043425341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2192",
            "city": "PEARL CITY",
            "state": "HI",
            "postal_code": "967829192",
            "telephone_number": "808-254-5468",
            "fax_number": "808-262-4437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "970 N KALAHEO AVE",
            "address_2": "A204",
            "city": "KAILUA",
            "state": "HI",
            "postal_code": "967341801",
            "telephone_number": "808-254-5468",
            "fax_number": "808-262-4437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "DUKE",
        "middle_name": "ELVIN",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "HI",
            "license": "PSY298",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA",
            "identifier": "0000003889",
            "state": "HI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00461901",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Holly Maria Viveiros, M.T.
• Larry Vo
• Kelly S Voelkel
• Love Volkova, D.O.
• Kenneth K Vu, M.D.
• Wendi Waits, MD
• Walgreen Co
• Beatrice Walter, MS. CCC-SLP
• Serena Marie Walters
• Thomas Walton, D.C.

• Psychologist in Kailua, HI
• Providers in Kailua, HI by specialty
• Psychologist in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.