David Van Wagner MD PC

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

Legal business name

DAVID VAN WAGNER MD PC

Practice address

2730 Pierce St Ste 204
Sioux City, IA 51104-3764

Phone

(712) 234-8787

Fax

(712) 234-8777

NPI assigned

Sep 27, 2012

Organization subpart

No

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

Authorized official

Name

David Van Wagner, M.D.NPI 1508836123

Title

Physician

Phone

(712) 234-8787

Specialties & licenses 1

Addresses

Other names 1

• Wagner Ear, Nose & Throat Doing business as

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Locations

Practitioners 3

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

• David V Wagner, MD

  • Otolaryngology Physician
  • Sioux City, IA
  • NPI 1508836123
  Medicare reassignment NPD Authorized official
• Stephanie Lanae Burger, M.D.

  • Otolaryngology Physician
  • Sioux City, IA
  • NPI 1992099402
  Medicare reassignment NPD
• Dwight L Birkley, PA-C

  • Physician Assistant
  • Sioux City, IA
  • NPI 1932179017
  Medicare reassignment

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

{
    "created_epoch": "1348704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352073600000",
    "number": "1194076349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 W 4TH ST STE 8",
            "city": "YANKTON",
            "state": "SD",
            "postal_code": "570783700",
            "telephone_number": "605-655-1414",
            "fax_number": "605-655-1420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2730 PIERCE ST STE 204",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511043764",
            "telephone_number": "712-234-8787",
            "fax_number": "712-234-8777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID VAN WAGNER MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-27",
        "last_updated": "2012-11-05",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "VAN",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "712-234-8787",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wagner Ear, Nose & Throat",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Daniel L Kaler DDS PC
• David H. Daniels, M.D.
• Danny L Whiting DDS PC
• Breanne Allen Danzi
• Lynda Darling, CADC
• Davis Dialysis LLC
• Austin Davis, TLMHC
• Cody Lee Davis, D.C.
• Evan M Davis, MD
• Mark Edward Davis, CNP

• Otolaryngology Physician in Sioux City, IA
• Providers in Sioux City, IA by specialty
• Otolaryngology Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.