Active NPI
William G Wagner, MD
- Vascular & Interventional Radiology Physician
- Sheboygan, WI
National Provider Identifier
1063473692
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular & Interventional Radiology Physician
- License
- 17431020
- Practice address
- 1601 N Taylor Dr
Sheboygan, WI 53081-1930 - Phone
- (920) 459-8300
- NPI assigned
- Mar 31, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vascular & Interventional Radiology Physician | 2085R0204X | 17431020 | WI | Primary |
Addresses
Primary practice location
1601 N Taylor Dr
Sheboygan, WI 53081-1930
Mailing address
2108 Kohler Memorial Dr
Ste 101
Sheboygan, WI 53081-3100
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17431020 | WI | MD | Vascular & Interventional Radiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143763200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1063473692",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2108 KOHLER MEMORIAL DR",
"address_2": "STE 101",
"city": "SHEBOYGAN",
"state": "WI",
"postal_code": "530813100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1601 N TAYLOR DR",
"city": "SHEBOYGAN",
"state": "WI",
"postal_code": "530811930",
"telephone_number": "920-459-8300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGNER",
"first_name": "WILLIAM",
"middle_name": "G",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-31",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0204X",
"taxonomy_group": "",
"desc": "Radiology, Vascular & Interventional Radiology",
"state": "WI",
"license": "17431020",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sheboygan, WI
- Melissa Ann Waara, RDH
- Lisa Ann Wachowiak, COTA
- Jessica Ann Wagner, OTR/L
- Jodi Lynn Wagner, OTR
- Lindsay Nicole Wagner, RN
- Jeremy M Wagnon, D.C.
- Justin Dean Wahl Adame, SAC-IT
- Wal-Mart Stores East LP (Wal-Mart Vision Center 30-1276)
- Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-1276)
- Wal-Mart Stores East LP (Walmart Pharmacy 10-3324)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.