Individual provider Active NPI

Cynthia S. Wagnon, M.D.

  • Internal Medicine Physician
  • Delhi, LA
National Provider Identifier
1225009053
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
022391 Issued in LA
Practice address
508 Broadway St
Delhi, LA 71232-3002
Phone
(318) 878-3737
Fax
(318) 878-8638
NPI assigned
Jan 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 022391 LA Primary

Addresses

Primary practice location

508 Broadway St
Delhi, LA 71232-3002

Mailing address

508 Broadway St
Delhi, LA 71232-3002
Phone (318) 878-3737

Other identifiers 2

IdentifierTypeStateIssuer
022391OtherLALICENSE
1495891MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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

Enrollment IDStateProvider typePAC IDDetails
I20100713000738 LA Practitioner - Internal Medicine 3476685348 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Louisiana State University School of Medicine in Shreveport, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospital Service District No 1a of the Parish of Richland State of laGroup PAC ID 1456307230, shared by 10 NPIs, 31 clinicians

Practice addresses (Care Compare)

407 Cincinnati St
Delhi, LA 71232-3007

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Service District No 1-a of the Parish of Richland State of la Internal Medicine CurrentSince Apr 1, 1997 Accepting new patients
Hospital Service District No 1-a of the Parish of Richland State of la Current Accepting new patients
Hospital Service District No 1-a of the Parish of Richland State of la CurrentSince Apr 1, 1997 Accepting new patients

Locations

508 Broadway St
Delhi, LA 71232
Phone (318) 878-3737

407 Cincinnati St
Delhi, LA 71232
Phone (318) 878-5171

501 Broadway St
Delhi, LA 71232
Phone (318) 878-6650

Interoperability endpoints

  • Direct secure messaging: cynthia.wagnon.1@13199.direct.athenahealth.com

Organizations & group practices 3

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.

Hospital & facility affiliations 4

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": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225009053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 BROADWAY ST",
            "city": "DELHI",
            "state": "LA",
            "postal_code": "712323002",
            "telephone_number": "318-878-3737",
            "fax_number": "318-878-8638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 BROADWAY ST",
            "city": "DELHI",
            "state": "LA",
            "postal_code": "712323002",
            "telephone_number": "318-878-3737",
            "fax_number": "318-878-8638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNON",
        "first_name": "CYNTHIA",
        "middle_name": "S.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "022391",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "022391",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1495891",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Delhi, LA

Sources for this page

Verify at the official NPI Registry.