Individual provider Active NPI

Lloyd David Wagner, M.D.

  • Diagnostic Radiology Physician
  • Camden, NJ
National Provider Identifier
1124161872
Registry record updated Aug 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
25MA09610500 Issued in NJ
Practice address
1 Cooper PLZ
Camden, NJ 08103-1461
Phone
(888) 499-8779
NPI assigned
Feb 14, 2007
Last updated
Aug 28, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2026

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

Specialties & licenses 12

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X TM2014-0943 NM
Diagnostic Radiology Physician 2085R0202X MD38592 SC
Diagnostic Radiology Physician 2085R0202X MD453925 PA
Diagnostic Radiology Physician 2085R0202X MD.MD.60512260 WA
Diagnostic Radiology Physician 2085R0202X 164449 NY
Diagnostic Radiology Physician 2085R0202X 036136834 IL
Diagnostic Radiology Physician 2085R0202X 53879 CT
Diagnostic Radiology Physician 2085R0202X 2015016614 MO
Diagnostic Radiology Physician 2085R0202X G70226 CA
Diagnostic Radiology Physician 2085R0202X 2015-00267 NC
Diagnostic Radiology Physician 2085R0202X 25MA09610500 NJ Primary
Diagnostic Radiology Physician 2085R0202X 01074785A IN

Addresses

Primary practice location

1 Cooper PLZ
Camden, NJ 08103-1461

Mailing address

1 Federal St Ste 200
Camden, NJ 08103-1088
Phone (848) 288-6935

Other practice location 1

5501 Old York Rd
Philadelphia, PA 19141-3018
Phone (215) 456-6200

Other practice location 2

1014 Oswegatchie Trail Rd
Star Lake, NY 13690-3143
Phone (315) 848-3351

Other practice location 3

3330 W 177th St Ste 1D
Hazel Crest, IL 60429-2185
Phone (708) 799-4940

Other practice location 4

457 Lake Cook Rd
Deerfield, IL 60015-5202
Phone (847) 291-9321

Other practice location 5

1959 NE Pacific St
Seattle, WA 98195-0001
Phone (206) 520-5000

Other practice location 6

28 Crescent St
Middletown, CT 06457-3654
Phone (860) 358-6000

Other practice location 7

3838 N Main St Ste 1A
Mishawaka, IN 46545-3100
Phone (574) 257-4674

Other practice location 8

2560 Samaritan Dr
Las Cruces, NM 88001-1170
Phone (575) 800-3868

Other practice location 9

125 Wamsutta Mill Rd Ste C
Morganton, NC 28655-5522
Phone (828) 430-3511

Other practice location 10

4 Carriage Ln Ste 108
Charleston, SC 29407-6048
Phone (828) 430-3511

Other practice location 11

6000 Hospital Dr
Hannibal, MO 63401-6887
Phone (573) 248-5300

Other practice location 12

223 24th St
Santa Monica, CA 90402-2515
Phone (952) 595-1100

Other identifiers 1

IdentifierTypeStateIssuer
01074785AOtherININDIANA LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, NY, AZ, IL, TN, MO, IN, WI, FL, OH, PA, KS, GA, NJ, NC, SC, OR, TX, NV, MN, IA, MS, LA, KY, OK, AL, NH, AR, VA, HI, CO, WA, MI, NM, CT35 enrollments
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 35

Enrollment IDStateProvider typePAC IDDetails
I20100811000543 CA Practitioner - Diagnostic RadiologyPractitioner - Other (Physician) 3870517923 Reassigns benefits to 60 organizations
I20150325001217 NY Practitioner - Diagnostic Radiology 3870517923 Reassigns benefits to 22 organizations
I20160613001808 AZ Practitioner - Diagnostic RadiologyPractitioner - Family Practice 3870517923 Reassigns benefits to 4 organizations
I20161024002610 IL Practitioner - Diagnostic Radiology 3870517923 Reassigns benefits to 12 organizations
I20170925001423 TN Practitioner - Diagnostic Radiology 3870517923 Reassigns benefits to 3 organizations
I20180926001717 MO Practitioner - Diagnostic Radiology 3870517923 Reassigns benefits to 3 organizations
I20181008001492 IN Practitioner - Diagnostic Radiology 3870517923 Reassigns benefits to 3 organizations
I20181018001309 WI Practitioner - Diagnostic Radiology 3870517923 Reassigns benefits to 2 organizations
I20181029001815 FL Practitioner - Diagnostic Radiology 3870517923 Reassigns benefits to 8 organizations
I20181105003187 OH Practitioner - Diagnostic Radiology 3870517923 Reassigns benefits to 6 organizations
I20181107000480 PA Practitioner - Diagnostic Radiology 3870517923 Reassigns benefits to 14 organizations
I20181114000133 KS Practitioner - Diagnostic Radiology 3870517923 Reassigns benefits to 2 organizations
I20181128003630 GA Practitioner - Diagnostic Radiology 3870517923 Reassigns benefits to 10 organizations
I20181211001224 NJ Practitioner - Diagnostic Radiology 3870517923 Reassigns benefits to 8 organizations
I20181229000040 NC Practitioner - Diagnostic Radiology 3870517923 Reassigns benefits to 4 organizations
I20190123000167 SC Practitioner - Diagnostic Radiology 3870517923 Reassigns benefits to 4 organizations
I20191204000308 OR Practitioner - Diagnostic Radiology 3870517923 Reassigns benefits to 1 organization
I20200716003562 TX Practitioner - Diagnostic Radiology 3870517923 Reassigns benefits to 7 organizations
I20201104000841 NV Practitioner - Diagnostic Radiology 3870517923 Reassigns benefits to 3 organizations
I20201214002058 MN Practitioner - Diagnostic Radiology 3870517923 Reassigns benefits to 1 organization
I20210210002909 IA Practitioner - Diagnostic Radiology 3870517923 Reassigns benefits to 1 organization
I20211104000755 MS Practitioner - Diagnostic Radiology 3870517923 Reassigns benefits to 3 organizations
I20220922000926 LA Practitioner - Diagnostic Radiology 3870517923 Reassigns benefits to 1 organization
I20221004002112 KY Practitioner - Diagnostic Radiology 3870517923 Reassigns benefits to 7 organizations
I20230412000052 OK Practitioner - Diagnostic Radiology 3870517923
I20230510000846 AL Practitioner - Diagnostic Radiology 3870517923 Reassigns benefits to 4 organizations
I20230511001394 NH Practitioner - Diagnostic Radiology 3870517923 Reassigns benefits to 1 organization
I20240621000052 AR Practitioner - Diagnostic Radiology 3870517923 Reassigns benefits to 1 organization
I20240719003501 VA Practitioner - Diagnostic Radiology 3870517923 Reassigns benefits to 1 organization
I20241224000716 HI Practitioner - Diagnostic Radiology 3870517923 Reassigns benefits to 2 organizations
I20250128000236 CO Practitioner - Diagnostic Radiology 3870517923 Reassigns benefits to 1 organization
I20250211003237 WA Practitioner - Diagnostic Radiology 3870517923 Reassigns benefits to 2 organizations
I20250403002965 MI Practitioner - Diagnostic Radiology 3870517923 Reassigns benefits to 2 organizations
I20260424003582 NM Practitioner - Diagnostic Radiology 3870517923 Reassigns benefits to 3 organizations
I20260625004542 CT Practitioner - Diagnostic Radiology 3870517923 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mississippi Hma Hospitalists LLCGroup PAC ID 5991972077, 55 clinicians
Imaging Consultants of Central Illinois SCGroup PAC ID 6800275900, 12 clinicians
Regional Imaging AssociatesGroup PAC ID 7113372236, 22 clinicians
Rwjbh Observation Associates LLCGroup PAC ID 5193137503, 995 clinicians
Dubois Regional Medical CenterGroup PAC ID 5890689715, 424 clinicians
White-Wilson Medical Center PAGroup PAC ID 4082510607, 48 clinicians
Clifton-Fine Healthcare CorporationGroup PAC ID 9739090382, 17 clinicians
Proscan NCH Imaging LLCGroup PAC ID 6103233051, 104 clinicians
Ali M Gharagozloo MD PCGroup PAC ID 0446228472, 7 clinicians
Community Medical Imaging IncGroup PAC ID 7810211067, 4 clinicians
Radiology Associates of Oxford - PAGroup PAC ID 1052309424, 13 clinicians
St Lawrence Radiology Assoc PCGroup PAC ID 2264421122, 25 clinicians
Regional Imaging Enm LLCGroup PAC ID 2264847128, 19 clinicians
Elite Imaging LLCGroup PAC ID 2466496880, 126 clinicians
Radiologic Consultants, LTDGroup PAC ID 3971498841, 20 clinicians
Ancillary Services of Practice Associates PAGroup PAC ID 4981026192, 99 clinicians
Washington Physician ServicesGroup PAC ID 6103719562, 106 clinicians
Flowers HB Medical Services LLCGroup PAC ID 6305290990, 139 clinicians
Great Lakes Radiology ServicesGroup PAC ID 7113456831, 32 clinicians
Scranton Hospitalist Physician Services LLCGroup PAC ID 7719163831, 46 clinicians
Olean Radiology, PCGroup PAC ID 9133118862, 16 clinicians
Vpa PCGroup PAC ID 9234041948, 181 clinicians
SMB Radiology P aGroup PAC ID 9234136060, 22 clinicians
Bertrand Chaffee HospitalGroup PAC ID 0840273496, 32 clinicians
Procare Medical Group SCGroup PAC ID 0840277265, 16 clinicians
Fresno Imaging CenterGroup PAC ID 2466553128, 127 clinicians
Desert Advanced Imaging Medical CenterGroup PAC ID 6406749613, 209 clinicians
Rightcare Clinic PCGroup PAC ID 3779920806, 13 clinicians
Kittusamy LLCGroup PAC ID 8820171911, 9 clinicians
Health Services of Central GeorgiaGroup PAC ID 9638076730, 300 clinicians

Practice addresses (Care Compare)

Santa Monica, CA 90402
Phone (601) 376-8206

1 Clara Maass Dr
Belleville, NJ 07109-3550
Phone (973) 450-2000

100 Hospital Ave
Du Bois, PA 15801-1440
Phone (814) 375-3261

1000 Rush Dr
Salida, CO 81201-9627
Phone (719) 530-2200

1005 Mar Walt Dr
Fort Walton Beach, FL 32547-6707
Phone (850) 863-8150

1014 Oswegatchie Trail Rd
Star Lake, NY 13690-3143
Phone (315) 848-3351

1020 Crosspointe Dr
Suite 103
Naples, FL 34110-0918
Phone (239) 598-0035

11903 Panama City Beach Pkwy
A
Panama City Beach, FL 32407-2605
Phone (850) 253-0189

16130 Ventura Blvd
Suite 100
Encino, CA 91436-2517
Phone (818) 933-2020

163 River Oaks Dr
Suite 201
Canton, MS 39046-5324
Phone (601) 496-1000

1821 W Olive Ave
Burbank, CA 91506-2435
Phone (818) 841-8880

214 King St
Ogdensburg, NY 13669-1142
Phone (315) 393-3600

2200 N Section St
Sullivan, IN 47882-7523
Phone (812) 268-4311

223 24TH St
Santa Monica, CA 90402-2515
Phone (877) 848-1457

224 E Main St
Springville, NY 14141-1443
Phone 71659228711202

238 S Congress St
Rushville, IL 62681-1465
Phone (217) 322-5296

25395 Hancock Ave
Suite 110
Murrieta, CA 92562-9054
Phone (951) 696-4230

2550 Samaritan Dr
Las Cruces, NM 88001-1170
Phone (800) 421-8274

2560 Samaritan Dr
Las Cruces, NM 88001-1170
Phone (575) 800-3868

2601 W Alameda Ave
Bubank, CA 91505-4810
Phone (818) 843-7462

2679 Zoe Ave
Huntington Park, CA 90255-4144
Phone (323) 584-3333

2705 Loma Vista Rd
Suite 100
Ventura, CA 93003-1595
Phone (805) 988-0616

2708 E Willow St
Signal Hill, CA 90755-2217
Phone (562) 216-5120

2950 Sycamore Dr
Simi Valley, CA 93065-1210
Phone (805) 357-0067

31775 De Portola Rd
Temecula, CA 92592-2742
Phone (951) 238-6070

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15730NVMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
53879CTMDDiagnostic Radiology Physician
25MA09610500NJMDDiagnostic Radiology Physician
TM2014-0943NMMDDiagnostic Radiology Physician
164449NYMDDiagnostic Radiology Physician
MD453925PAMDDiagnostic Radiology Physician

Practice roles (60 of 226)

OrganizationSpecialtyStatusNew patients
Proscan NCH Imaging LLC Diagnostic Radiology CurrentSince Feb 15, 2022 Accepting new patients
Schuyler County Hospital District CurrentSince Sep 18, 2025 Accepting new patients
Scranton Hospitalist Physician Services LLC Diagnostic Radiology CurrentSince May 1, 2025 Accepting new patients
LCM Imaging Inc Diagnostic Radiology CurrentSince Apr 28, 2026 Accepting new patients
Maui Diagnostic Imaging LLC Diagnostic Radiology CurrentSince Jul 17, 2023 Accepting new patients
One Step Diagnostic III, L.P. CurrentSince Aug 8, 2025 Accepting new patients
Stat Portable X-Ray Inc CurrentSince Apr 1, 2017 Accepting new patients
Kan-Di-Ki LLC CurrentSince Mar 1, 2019 Accepting new patients
West Virginia Radiology Associates PC Diagnostic Radiology CurrentSince Aug 28, 2024 Accepting new patients
Dubois Regional Medical Center Diagnostic Radiology CurrentSince May 1, 2023 Accepting new patients
Round Rock Imaging LLC CurrentSince Jan 1, 2026 Accepting new patients
Amboy Medical Practice PC Diagnostic Radiology CurrentSince Feb 18, 2024 Accepting new patients
Cal Devon Urgent Care Inc Diagnostic Radiology CurrentSince Sep 20, 2016 Accepting new patients
Medical Technology Transfer Corporation Current Accepting new patients
Valdosta Family Medicine Associates, P.C. Family Medicine CurrentSince Oct 15, 2024 Accepting new patients
Beverly Radiology Medical Group III Diagnostic Radiology CurrentSince Apr 1, 2025 Accepting new patients
Kan-Di-Ki LLC CurrentSince Dec 7, 2024 Accepting new patients
Covenant Pathology Associates, PC Diagnostic Radiology CurrentSince Feb 1, 2022 Accepting new patients
Memphis Physicians Radiological Group PC Diagnostic Radiology CurrentSince Jul 1, 2022 Accepting new patients
Mississippi State Hospital CurrentSince Oct 1, 2025 Accepting new patients
Trumbull Radiologists Inc Diagnostic Radiology CurrentSince Oct 24, 2022 Accepting new patients
Ancillary Services of Practice Associates PA Diagnostic Radiology CurrentSince Apr 1, 2025 Accepting new patients
State of Mississippi - University of Mississippi Medical Center Current Accepting new patients
St Lawrence Radiology Assoc PC Diagnostic Radiology CurrentSince Nov 15, 2022 Accepting new patients
Mississippi Hma Hospitalists, LLC Diagnostic Radiology CurrentSince Dec 16, 2024 Accepting new patients
Allied Mobile Imaging, LLC CurrentSince Apr 20, 2021 Accepting new patients
Central New York Brain & Spine Neurosurgery PLLC CurrentSince Jan 1, 2023 Accepting new patients
Preferred Imaging of Mesquite LLC Diagnostic Radiology CurrentSince Jan 1, 2026 Accepting new patients
County of Clay CurrentSince Mar 1, 2025 Accepting new patients
Kan-Di-Ki LLC CurrentSince Sep 1, 2020 Accepting new patients
Mantro Mobile Imaging LLC CurrentSince Jan 1, 2017 Accepting new patients
Schuyler County Hospital District CurrentSince Sep 18, 2025 Accepting new patients
Preferred Imaging of McKinney, LLC Diagnostic Radiology CurrentSince Jan 1, 2026 Accepting new patients
Preferred Open MRI, LLC Diagnostic Radiology CurrentSince Jan 1, 2026 Accepting new patients
Medical Technology Transfer Corporation CurrentSince Oct 18, 2021 Accepting new patients
Imaging Center of West Palm Beach LLC CurrentSince Jan 1, 2026 Accepting new patients
J-Preet Inc CurrentSince Jan 1, 2019 Accepting new patients
Proscan Radiology Northern Kentucky, LLC Diagnostic Radiology CurrentSince Jun 23, 2022 Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Jul 6, 2025 Accepting new patients
Quimson Development LLC CurrentSince Apr 1, 2026 Accepting new patients
Shores Diagnostic LLC CurrentSince Apr 5, 2021 Accepting new patients
Clifton-Fine Healthcare Corporation Family Medicine CurrentSince Jul 14, 2024 Accepting new patients
Owensboro Health Medical Group Inc Current Accepting new patients
County of Clay CurrentSince Mar 1, 2025 Accepting new patients
Mobile Images Acquisition, LLC CurrentSince Apr 1, 2019 Accepting new patients
Ultra Healthcare Services, Inc CurrentSince Apr 23, 2016 Accepting new patients
Peace Health Partners, PC Diagnostic Radiology CurrentSince Apr 1, 2026 Accepting new patients
O C Mobile Imaging Diagnostic Radiology CurrentSince Feb 5, 2025 Accepting new patients
Medical Imaging Specialist in Inc CurrentSince Oct 7, 2025 Accepting new patients
Bertrand Chaffee Hospital CurrentSince Sep 19, 2025 Accepting new patients
90 Minute Diagnostics LLC Diagnostic Radiology CurrentSince Mar 16, 2024 Accepting new patients
Schuylkill Open MRI Inc CurrentSince Jun 1, 2025 Accepting new patients
KND Development 59 LLC CurrentSince May 26, 2019 Accepting new patients
National Mobile X-Ray LLC CurrentSince Sep 1, 2018 Accepting new patients
Owensboro Health Medical Group Inc CurrentSince Jan 1, 2025 Accepting new patients
Mobile X-Ray of Austin Inc CurrentSince Apr 13, 2021 Accepting new patients
Washington Physician Services Family Medicine CurrentSince Sep 21, 2025 Accepting new patients
Mobile Visions Inc CurrentSince May 7, 2025 Accepting new patients
Vpa PC Family Medicine CurrentSince Apr 24, 2021 Accepting new patients
Quality Medical Imaging of Washington Inc CurrentSince Jun 1, 2019 Accepting new patients

Locations (25 of 214)

4370 W Main St
Dothan, AL 36305
Phone (256) 332-1611

623 N 9th St
#40
Augusta, AR 72006

1530 N Church St
#55
Jonesboro, AR 72401
Phone (870) 802-3586

4915 E Baseline Rd
Ste 116
Gilbert, AZ 85234
Phone (480) 354-9200

2538 E University Dr
Ste F220
Phoenix, AZ 85034
Phone (602) 281-4221

7776 S Pointe Pkwy W
Ste 150
Phoenix, AZ 85044
Phone (602) 281-4225

7776 S Pointe Pkwy W
Ste 150A
Phoenix, AZ 85044
Phone 8007868015 ext. 76191

2501 E Southern Ave
Ste 811
Tempe, AZ 85282
Phone (480) 820-2021

7717 N Hartman Ln
Tucson, AZ 85743
Phone (520) 744-6121

11510 S Fortuna Rd
Ste A
Yuma, AZ 85367
Phone (928) 342-7046

18523 Corwin Rd
Ste J
Apple Valley, CA 92307
Phone (760) 242-4444

2301 Bahamas Dr
Bakersfield, CA 93309

3838 San Dimas St
Ste A120
Bakersfield, CA 93301
Phone (661) 328-9600

9330 Stockdale Hwy
Ste 100
Bakersfield, CA 93311
Phone (661) 325-6800

8750 Wilshire Blvd
Ste 100
Beverly Hills, CA 90211
Phone (310) 689-3100

2601 W Alameda Ave
Ste 101
Burbank, CA 91505
Phone (818) 843-7462

2820 N Ontario St
Burbank, CA 91504
Phone (818) 480-9100

801 S Main St
Ste 101
Corona, CA 92882
Phone (951) 682-1099

801 S Main St
Ste 205
Corona, CA 92882
Phone (951) 351-1025

16130 Ventura Blvd
Ste 100
Encino, CA 91436
Phone (818) 933-2020

6107 N Fresno St
Ste 101
Fresno, CA 93710
Phone (559) 435-4433

9191 Westminster Ave
Ste 105
Garden Grove, CA 92844
Phone (714) 583-6314

250 S 12th Ave
Hanford, CA 93230
Phone (559) 295-2450

2679 Zoe Ave
Huntington Park, CA 90255
Phone (323) 584-3333

11360 Mountain View Ave
Ste C
Loma Linda, CA 92354
Phone (909) 478-3300

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/18762/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir.yourcareuniverse.net/tenant/a7b918c3-56d9-410c-bec6-e3d86fde3f92
  • FHIR API: https://fhir4.healow.com/fhir/r4/CHFDAA
  • Direct secure messaging: lloyd.wagner.1@11356.direct.athenahealth.com
  • Direct secure messaging: lloyd.wagner.1@21123.direct.athenahealth.com
  • Direct secure messaging: lloyd.wagner@direct.bayonnemedicalcenter.md
  • Direct secure messaging: lloydwagner@asjh.medalliesdirect.net
  • Direct secure messaging: lwagner219384@ummc.direct-ci.com

Organizations & group practices 270

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.

View all 270

Hospital & facility affiliations 12

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

NPI Registry JSON

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787875200000",
    "number": "1124161872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FEDERAL ST STE 200",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031088",
            "telephone_number": "848-288-6935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 COOPER PLZ",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031461",
            "telephone_number": "888-499-8779"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5501 Old York Rd",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191413018",
            "country_code": "US",
            "telephone_number": "215-456-6200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1014 Oswegatchie Trail Rd",
            "address_purpose": "LOCATION",
            "city": "Star Lake",
            "state": "NY",
            "postal_code": "136903143",
            "country_code": "US",
            "telephone_number": "315-848-3351",
            "fax_number": "315-848-3285",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3330 W 177th St Ste 1D",
            "address_purpose": "LOCATION",
            "city": "Hazel Crest",
            "state": "IL",
            "postal_code": "604292185",
            "country_code": "US",
            "telephone_number": "708-799-4940",
            "fax_number": "708-799-0641",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "457 Lake Cook Rd",
            "address_purpose": "LOCATION",
            "city": "Deerfield",
            "state": "IL",
            "postal_code": "600155202",
            "country_code": "US",
            "telephone_number": "847-291-9321",
            "fax_number": "847-291-9362",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1959 NE Pacific St",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981950001",
            "country_code": "US",
            "telephone_number": "206-520-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "28 Crescent St",
            "address_purpose": "LOCATION",
            "city": "Middletown",
            "state": "CT",
            "postal_code": "064573654",
            "country_code": "US",
            "telephone_number": "860-358-6000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3838 N Main St Ste 1A",
            "address_purpose": "LOCATION",
            "city": "Mishawaka",
            "state": "IN",
            "postal_code": "465453100",
            "country_code": "US",
            "telephone_number": "574-257-4674",
            "fax_number": "574-257-0549",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2560 Samaritan Dr",
            "address_purpose": "LOCATION",
            "city": "Las Cruces",
            "state": "NM",
            "postal_code": "880011170",
            "country_code": "US",
            "telephone_number": "575-800-3868",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "125 Wamsutta Mill Rd Ste C",
            "address_purpose": "LOCATION",
            "city": "Morganton",
            "state": "NC",
            "postal_code": "286555522",
            "country_code": "US",
            "telephone_number": "828-430-3511",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4 Carriage Ln Ste 108",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294076048",
            "country_code": "US",
            "telephone_number": "828-430-3511",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6000 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Hannibal",
            "state": "MO",
            "postal_code": "634016887",
            "country_code": "US",
            "telephone_number": "573-248-5300",
            "fax_number": "573-248-5302",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "223 24th St",
            "address_purpose": "LOCATION",
            "city": "Santa Monica",
            "state": "CA",
            "postal_code": "904022515",
            "country_code": "US",
            "telephone_number": "952-595-1100",
            "fax_number": "612-294-4903",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "LLOYD",
        "middle_name": "DAVID",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-14",
        "last_updated": "2026-08-28",
        "certification_date": "2026-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NM",
            "license": "TM2014-0943",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "SC",
            "license": "MD38592",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD453925",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WA",
            "license": "MD.MD.60512260",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "164449",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036136834",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CT",
            "license": "53879",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "2015016614",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "G70226",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": "2015-00267",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NJ",
            "license": "25MA09610500",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IN",
            "license": "01074785A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIANA LICENSE",
            "identifier": "01074785A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Camden, NJ

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Verify at the official NPI Registry.