Jaime Stephan Wagner, D.O.

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

License

2012-00139 Issued in NC

Practice address

1331 N Elm St Ste 200
Greensboro, NC 27401-6304

Phone

(336) 274-9617

Fax

(336) 482-2177

NPI assigned

Jan 3, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in NC, VA2 enrollments

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 2

Specialty

Diagnostic Radiology

Education

Edward Via Col of Osteo Medicine-Virginia Campus, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Danville Physician Practices LLCGroup PAC ID 4688606304, 171 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sovah Health Danville Hospital, Danville, VA, CCN 490075
• Danville Regional Medical Ctr Inpatient rehabilitation facility, Danville, VA, CCN 49T075

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jaime.wagner.1@19847.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/19847/brand/3/csg/21/fhir/r4
• Direct secure messaging: jwagner2791749@carolinashealthcaresystem.direct-ci.com

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.

• Danville Physician Practices LLC

  • Anesthesiology Physician
  • Danville, VA
  • NPI 1629022868
  Medicare reassignment Care Compare group NPD
• Diagnostic Radiology & Imaging LLC

  • Diagnostic Radiology Physician
  • Greensboro, NC
  • NPI 1265469795
  Medicare reassignment NPD
• Imrad of Virginia PLLC

  • Diagnostic Radiology Physician
  • Woodbridge, VA
  • NPI 1457816522

  NC

  Medicare reassignment NPD
• Martinsville Physician Practices LLC

  • Internal Medicine Physician
  • Martinsville, VA
  • NPI 1255380887
  Medicare reassignment NPD
• Greensboro Pathology, LLC

  • Clinical Medical Laboratory
  • Greensboro, NC
  • NPI 1952396202
  NPD
• Greensboro Radiology, PA

  • Diagnostic Radiology Physician
  • Greensboro, NC
  • NPI 1821035999
  NPD
• Pinnacle Health Services of North Carolina LLC

  • Radiology Clinic/Center
  • Raleigh, NC
  • NPI 1457300089

  Diagnostic Radiology

  NPD
• Pinnacle Health Services of North Carolina, LLC

  • Radiology Clinic/Center
  • Clayton, NC
  • NPI 1548454127

  Diagnostic Radiology

  NPD
• The Moses H Cone Memorial Hospital Operating Corporation

  • Physiological Laboratory
  • Asheboro, NC
  • NPI 1386451573
  NPD
• The Moses H. Cone Memorial Hospital Operating Corporation

  • Physiological Laboratory
  • Asheboro, NC
  • NPI 1669289856
  NPD
• The Moses H. Cone Memorial Hospital Operating Corporation

  • Radiology Clinic/Center
  • Asheboro, NC
  • NPI 1982423638
  NPD
• Danville Physician Practices LLC

  • Diagnostic Radiology Physician
  • Danville, VA
  • NPI 1265243612
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Danville Regional Medical Center LLC

  • General Acute Care Hospital
  • Martinsville, VA
  • NPI 1386720183
  Care Compare affiliation
• Danville Regional Medical Center, LLC

  • Rural Acute Care Hospital
  • Danville, VA
  • NPI 1154419737
  Care Compare affiliation
• Danville Regional Medical Center, LLC

  • Rehabilitation Hospital Unit
  • Danville, VA
  • NPI 1275606113

  Inpatient rehabilitation facility

  Care Compare affiliation

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

{
    "created_epoch": "1199318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678406400000",
    "number": "1306021704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 63112",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282633112",
            "telephone_number": "336-274-9617",
            "fax_number": "336-482-2177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1331 N ELM ST STE 200",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274016304",
            "telephone_number": "336-274-9617",
            "fax_number": "336-482-2177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "JAIME",
        "middle_name": "STEPHAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-03",
        "last_updated": "2023-03-10",
        "certification_date": "2023-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OR",
            "license": "162768",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": "2012-00139",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NC",
            "license": "2012-00139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deiandra Shaneyce Wade, LPCA
• Tandra Wade, MSW,LCSWA
• Wilda Faye Wade, PH.D.,RD, LDN
• Rebeccah Nanjala Wafula
• Bethany Ruth Wagler, DNP, AGPCNP-BC
• Lorena Wagner
• Suzanne Wagner, MD
• Lynn Wagoner
• Matthew Roy Wagoner, DPM
• Robert A Wainer, MD

• Vascular & Interventional Radiology Physician in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Vascular & Interventional Radiology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.