John Herbert Wagner, R. PH.

Primary specialty

PharmacistTaxonomy code 183500000X

License

8002-40 Issued in WI

Practice address

3900 Erie St
Racine, WI 53402-3544

Phone

(262) 639-1611

Fax

(262) 639-5611

NPI assigned

Mar 30, 2015

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

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

{
    "created_epoch": "1427673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427673600000",
    "number": "1235524075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 ERIE ST",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534023544",
            "telephone_number": "262-639-1611",
            "fax_number": "262-639-5611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 ERIE ST",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534023544",
            "telephone_number": "262-639-1611",
            "fax_number": "262-639-5611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "JOHN",
        "middle_name": "HERBERT",
        "name_prefix": "Mr.",
        "credential": "R. PH.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-30",
        "last_updated": "2015-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "8002-40",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1225062441",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Jean Voskuil, DPT
• Kristen M Voss, RN
• Indur Wadhwani, MD
• Jennifer Ann Wagener
• James A Wagner, CADCIII-RCS
• Richard M Wagner, DDS
• William Richard Wagner, M.S.W., A.P.S.W.
• Georges Wakim, LAT
• Walgreen Co
• Walgreen Co

• Pharmacist in Racine, WI
• Providers in Racine, WI by specialty
• Pharmacist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.