Lisa Wagner, NP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

430343 Issued in NY

Practice address

1250 Broadway, 17TH Floor
Visiting Nurse Service of New York
New York, NY 10001

Phone

(212) 465-2751

NPI assigned

May 23, 2007

Sex

Female

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413936000000",
    "number": "1083824593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 E 87TH ST",
            "address_2": "PH2B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101282214",
            "telephone_number": "917-492-8702",
            "fax_number": "917-492-8702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 BROADWAY, 17TH FLOOR",
            "address_2": "VISITING NURSE SERVICE OF NEW YORK",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10001",
            "telephone_number": "212-465-2751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "LISA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-23",
        "last_updated": "2014-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NY",
            "license": "430343",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS HEALTH COMMERCE SYSTEM",
            "identifier": "LW385602",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Josh Wagner, DC
• Karen B Wagner, MD
• Kayla Wagner, CPNP-PC
• Lauren Wagner, MD
• Leslie Wagner, MS,CCC
• Lucy Wagner
• Lynda Jeanne Wagner
• Madlen Wagner
• Matthew John Wagner, DO
• Meredith A Wagner, M.D

• Acute Care Nurse Practitioner in New York, NY
• Providers in New York, NY by specialty
• Acute Care Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2014; 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.