Scott Brian Wagner, D.C.

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

0104555923 Issued in VA

Practice address

2109 India Rd
Charlottesville, VA 22901-2886

Phone

(434) 978-4888

Fax

(434) 978-3633

NPI assigned

Jun 30, 2006

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

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Specialty

Chiropractic

Education

Life Chiropractic College, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Scott Wagner Integrated Medicine LLCGroup PAC ID 1153749825, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Scott Wagner Integrated Medicine LLC

  • General Practice Physician
  • Charlottesville, VA
  • NPI 1447875042
  Medicare reassignment Care Compare group Authorized official
• Advanced Pain Management of Virginia LLC

  • General Practice Physician
  • Charlottesville, VA
  • NPI 1700637592
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676246400000",
    "number": "1053340588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2109 INDIA RD",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229012886",
            "telephone_number": "434-978-4888",
            "fax_number": "434-978-3633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2109 INDIA RD",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229012886",
            "telephone_number": "434-978-4888",
            "fax_number": "434-978-3633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "SCOTT",
        "middle_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2023-02-13",
        "certification_date": "2023-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "VA",
            "license": "0104555923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda A. Waggoner Fountain, MD
• James Nile Wagley, PHD
• Wagner Hearing Aid Service Inc (Wagner Hearing Aid Centers)
• Bruce Robert Wagner, CCC AUDIOLOGY
• Eric N Wagner
• Brianna Wagoner
• Carolyn Bean Wagoner, D.D.S.
• Sandra M Wagoner, OT
• Megan Marie Waguespack, MD
• Margaret Austin Wahle

• Sports Physician Chiropractor in Charlottesville, VA
• Providers in Charlottesville, VA by specialty
• Sports Physician Chiropractor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.