William Wagner, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME50930 Issued in FL

Practice address

6214 Johnson St
Hollywood, FL 33024-5932

Phone

(954) 967-2500

Fax

(954) 967-2511

NPI assigned

Nov 2, 2006

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 2

Medicare fee-for-service enrollment

Enrolled in FL

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

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.

• South Broward Hospital District

  • Critical Care Medicine (Internal Medicine) Physician
  • Hollywood, FL
  • NPI 1609884154
  Medicare reassignment NPD
• South Broward Hospital District

  • Home Infusion Therapy Pharmacy
  • Miramar, FL
  • NPI 1043656614
  NPD
• South Broward Hospital District

  • General Acute Care Hospital
  • Hollywood, FL
  • NPI 1780667923

  Family Medicine

  NPD

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461283200000",
    "number": "1255419511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 CORPORATE WAY",
            "address_2": "MPG DOOR D",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330253925",
            "telephone_number": "954-276-5663",
            "fax_number": "954-276-0301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6214 JOHNSON ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330245932",
            "telephone_number": "954-967-2500",
            "fax_number": "954-967-2511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2016-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME50930",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "ME50930",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "262317000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Trinh Le Vuong, PHARM.D.
• Dylan Ambrose Wadell, MD
• Abraham Wagner, DPM
• Edward Steven Wagner, MD
• Jason Fredrick Wagner, APRN, LMHC, MCAP
• Estrella N/a Wahnich
• Wal-Mart Stores East LP
• Wal-Mart Stores East, LP
• Walgreen Co
• Walgreen Co

• Family Medicine Physician in Hollywood, FL
• Providers in Hollywood, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.