NPIMap

Individual provider Active NPI

William Price Wagner, DO

  • Family Medicine Physician
  • Bellefonte, PA
National Provider Identifier
1073010823
Registry record updated Mar 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS021538 Issued in PA
Practice address
141 Medical Park LN
Bellefonte, PA 16823-9112
Phone
(814) 355-7322
Fax
(814) 355-9604
NPI assigned
Apr 9, 2018
Last updated
Mar 14, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS021538 PA Primary

Addresses

Primary practice location

141 Medical Park LN
Bellefonte, PA 16823-9112

Mailing address

1800 E Park Ave
State College, PA 16803-6701
Phone (814) 231-7100

Other practice location 1

1700 Old Gatesburg Rd Ste 310
State College, PA 16803-2276
Phone (844) 278-4600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20210824002084 PA Practitioner - Family Practice 7810392248 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Lake Erie College of Osteopathic Medicine, Erie, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians

Practice addresses (Care Compare)

141 Medical Park LN
Bellefonte, PA 16823-9112
Phone (814) 355-7322

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions18
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS021538PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Nittany Medical Center Health Services Inc Family Medicine CurrentSince Aug 1, 2022 Accepting new patients
Mount Nittany Medical Center Health Services Inc Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

141 Medical Park Ln
Bellefonte, PA 16823
Phone (814) 355-7322

143 Hospital Dr
Ste 302
State College, PA 16803
Phone (814) 278-4680

155 Wellness Way
State College, PA 16803
Phone (800) 367-0179

164 Greenview Dr
Ste 485
State College, PA 16803
Phone (814) 278-4898

1700 Old Gatesburg Rd
Ste 310
State College, PA 16803
Phone (814) 237-3122

1850 E Park Ave
Ste 201
State College, PA 16803
Phone (814) 234-8800

1850 E Park Ave
Ste 207
State College, PA 16803
Phone (814) 235-2480

2051 S Atherton St
State College, PA 16801
Phone (844) 278-4600

Organizations & group practices 3

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 34

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1523232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1073010823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 E PARK AVE",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168036701",
            "telephone_number": "814-231-7100",
            "fax_number": "814-238-0790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 MEDICAL PARK LN",
            "city": "BELLEFONTE",
            "state": "PA",
            "postal_code": "168239112",
            "telephone_number": "814-355-7322",
            "fax_number": "814-355-9604"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1700 Old Gatesburg Rd Ste 310",
            "address_purpose": "LOCATION",
            "city": "State College",
            "state": "PA",
            "postal_code": "168032276",
            "country_code": "US",
            "telephone_number": "844-278-4600",
            "fax_number": "814-237-7178",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "WILLIAM",
        "middle_name": "PRICE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-09",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS021538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellefonte, PA

Sources for this page

Verify at the official NPI Registry.