Lois Wagstrom M.D., P.C.

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

MDO21252 Issued in TN

Legal business name

LOIS WAGSTROM M.D., P.C.

Practice address

250 25TH Ave N
Suite 301
Nashville, TN 37203-1632

Phone

(615) 329-1822

Fax

(615) 327-3206

NPI assigned

Jun 30, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Lois Wagstrom, M.D.NPI 1902852544

Title

Owner

Phone

(615) 329-1822

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Locations

Practitioners 2

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

• Lois Wagstrom, M.D.

  • Plastic and Reconstructive Surgery Physician
  • Nashville, TN
  • NPI 1902852544
  Medicare reassignment NPD Authorized official
• Melissa Langley, MD

  • Dermatology Physician
  • Nashville, TN
  • NPI 1679629612
  NPD (past)

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

{
    "created_epoch": "1214784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218412800000",
    "number": "1265694376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 25TH AVE N",
            "address_2": "SUITE 301",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372031632",
            "telephone_number": "615-329-1822",
            "fax_number": "615-327-3206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 25TH AVE N",
            "address_2": "SUITE 301",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372031632",
            "telephone_number": "615-329-1822",
            "fax_number": "615-327-3206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOIS WAGSTROM M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-30",
        "last_updated": "2008-08-11",
        "status": "A",
        "authorized_official_last_name": "WAGSTROM",
        "authorized_official_first_name": "LOIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "615-329-1822",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "TN",
            "license": "MDO21252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Constantine Nikitas Logothetis, MD
• Melissa McGuire Logue, APRN
• Katherine Loh, MD
• Larkin Lohr
• Charlotte J Lohrey, M.D.
• Brooks Lokey
• Millary Lomax
• Rachael Leigh Lomax, AGACNP
• Frederick Lombard, M.D.
• Jessica Lombardi, LMSW

• Plastic and Reconstructive Surgery Physician in Nashville, TN
• Providers in Nashville, TN by specialty
• Plastic and Reconstructive Surgery Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2008; 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.