Davonia Nicole Wagner Michael, MD

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

200300848 Issued in NC

Practice address

495 Arbor Hill Rd Ste M
Kernersville, NC 27284-3335

Phone

(336) 883-0029

NPI assigned

Dec 12, 2006

Sex

Female

Sole proprietor

No

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

Enrolled in NC

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

Pathology

Education

University of North Carolina at Chapel Hill School of Medicine, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bethany Medical CenterGroup PAC ID 4486614575, 71 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

88.84 of 100Reported as group

Quality

70.27

Promoting interoperability

98

Improvement activities

40

Cost

77.52

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Bethany Medical Center

  • Internal Medicine Physician
  • High Point, NC
  • NPI 1952404188

  Anatomic Pathology & Clinical Pathology

  Medicare reassignment Care Compare group NPD
• Bethany Medical Center

  • Anatomic Pathology & Clinical Pathology Physician
  • Kernersville, NC
  • NPI 1619398997
  NPD
• Bethany Medical Center, PA

  • Family Medicine Physician
  • High Point, NC
  • NPI 1508459306
  NPD
• Avance Care, PA

  • Clinic/Center
  • Fuquay Varina, NC
  • NPI 1487845020
  NPD (past)
• Bethany Medical Center, PA

  • Cardiovascular Disease Physician
  • High Point, NC
  • NPI 1174722391
  NPD (past)

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621296000000",
    "number": "1144381401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 N LINDSAY ST",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272624303",
            "telephone_number": "336-883-0029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 ARBOR HILL RD STE M",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272843335",
            "telephone_number": "336-883-0029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHAEL",
        "first_name": "DAVONIA",
        "middle_name": "NICOLE WAGNER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NC",
            "license": "200300848",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5906844",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Catherine Denise Metheney, MD
• Sara Garrett Meyer, PHARMD
• Meylor Family Chiropractic, PC
• Adam Dean Meylor, DC
• Michael Doyle, D.D.S., P.L.L.C.
• Brittny L Mielke, FNP
• Robert M. Miguel, PHYSICAL THERAPIST
• Joseph Allen Mihalovich
• Milk Remedy LLC
• Andrea Kotys Miller, MS, CCC-SP

• Anatomic Pathology & Clinical Pathology Physician in Kernersville, NC
• Providers in Kernersville, NC by specialty
• Anatomic Pathology & Clinical Pathology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2021; 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.