Don J Wagoner, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

01019897 Issued in IN

Practice address

605 E 7TH St
Burlington, IN 46915-9441

Phone

(765) 566-3351

Fax

(765) 566-2250

NPI assigned

Jan 20, 2006

Last updated

May 15, 2009By the provider in NPPES

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

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)
• Wagoner Medical Center, LLC

  • Family Medicine Physician
  • Kokomo, IN
  • NPI 1194940080
  NPD (past)

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

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242345600000",
    "number": "1285614511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 38",
            "address_2": "605 E. 7TH ST.",
            "city": "BURLINGTON",
            "state": "IN",
            "postal_code": "469150038",
            "telephone_number": "765-566-3351",
            "fax_number": "765-566-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 E 7TH ST",
            "city": "BURLINGTON",
            "state": "IN",
            "postal_code": "469159441",
            "telephone_number": "765-566-3351",
            "fax_number": "765-566-2250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGONER",
        "first_name": "DON",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-20",
        "last_updated": "2009-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01019897",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100135360B",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy R Aeschliman, FNP-C
• Trustees of Purdue University (Family Health Clinic of Burlington)
• Wagoner Medical Center, LLC

• Family Medicine Physician in Burlington, IN
• Providers in Burlington, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.