DRS Wagner & Wagner PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

H4771 Issued in TX

Legal business name

DRS WAGNER & WAGNER PA

Practice address

124 E Wolters 2ND
Shiner, TX 77984-7109

Phone

(361) 594-3824

Fax

(361) 594-4104

NPI assigned

Mar 21, 2006

Organization subpart

No

Name

Ralph Wagner, MDNPI 1447231881

Title

Partner

Phone

(361) 594-3824

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ralph A Wagner, MD

  • Family Medicine Physician
  • Shiner, TX
  • NPI 1447231881

  Family Medicine, TX

  Medicare reassignment Care Compare group NPD Authorized official
• Marshall C Bishop, MD

  • Family Medicine Physician
  • Shiner, TX
  • NPI 1821079260

  Family Medicine, TX

  Medicare reassignment Care Compare group NPD
• Timothy J Wagner, MD

  • Family Medicine Physician
  • Shiner, TX
  • NPI 1851372619

  Family Medicine, TX

  Medicare reassignment Care Compare group NPD
• Kirsten Machicek Bussell, PA -C

  • Physician Assistant
  • Shiner, TX
  • NPI 1427568807

  TX

  Medicare reassignment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Medicare fee-for-service enrollment

Enrolled in TX

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 18, 2008.

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216339200000",
    "number": "1124087887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 965",
            "city": "SHINER",
            "state": "TX",
            "postal_code": "779840965",
            "telephone_number": "361-594-3824",
            "fax_number": "361-594-4104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 E WOLTERS 2ND",
            "city": "SHINER",
            "state": "TX",
            "postal_code": "779847109",
            "telephone_number": "361-594-3824",
            "fax_number": "361-594-4104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRS WAGNER & WAGNER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-21",
        "last_updated": "2008-07-18",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "RALPH",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "361-594-3824",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "H4771",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "00J16X",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "083112501",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "017726301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennie Moerbe Chrismon, PT
• Melanie Sue Cowan, D.D.S.
• Joanna L Davis, RPH
• Sloane Dolezal, LCSW
• Heather Brooke Domel
• Stacey Marie Fojtik, MS-SLP-CCC
• Gonzales Healthcare Systems
• Carolyn E Hilscher, RPH PHARMACIST
• Katie'S Pediatric Therapy Service
• Kerri Leigh Lange, MPT

• All providers in Shiner, TX
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2008; 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.