James M Wagner, D.C.

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

1457/PT Issued in MD

Practice address

107 Ridgely Ave
Ste. 11
Annapolis, MD 21401-1417

Phone

(410) 267-0033

Fax

(410) 267-0667

NPI assigned

Nov 1, 2006

Last updated

Jan 8, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Enrolled in MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

ChiropracticAlso: Physical Medicine and Rehabilitation

Education

Life Chiropractic College, 1988

Medicare assignment

May accept Medicare assignment

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Annapolis Back & Neck Center, LLC

  • Sports Physician Chiropractor
  • Annapolis, MD
  • NPI 1164796181
  Medicare reassignment NPD Authorized official
• Jon Holtzman Chiropractic, P.C.

  dba Annapolis Chiropractic Associates

  • Chiropractor
  • Annapolis, MD
  • NPI 1073760054
  NPD (past)

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357603200000",
    "number": "1083791818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 RIDGELY AVE",
            "address_2": "STE. 11",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214011417",
            "telephone_number": "410-267-0033",
            "fax_number": "410-267-0667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 RIDGELY AVE",
            "address_2": "STE. 11",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214011417",
            "telephone_number": "410-267-0033",
            "fax_number": "410-267-0667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "JAMES",
        "middle_name": "M",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2013-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "MD",
            "license": "1457/PT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "M155",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS FEP",
            "identifier": "W2090001",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachel Wacker, PTA
• Jody Morelock Waddell, DDS
• Vanessa L Wade
• Kristen Wadlington
• Ryan Matthew Wagener, RPH
• Jennah Castleman Wagner, DMD
• Matthew Phillip Wagner, M.D.
• Priya Tahiliani Wagner, M.D.
• Sarah Wagner
• John Harvey Wagoner, M.D., PH.D., MBA

• Sports Physician Chiropractor in Annapolis, MD
• Providers in Annapolis, MD by specialty
• Sports Physician Chiropractor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.