Clara Durie Wagner, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT.007110 Issued in OH

Practice address

2155 Allentown Rd
Lima, OH 45805-1705

Phone

(419) 228-3800

NPI assigned

Feb 8, 2023

Last updated

Feb 8, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dickman Kettler and Bruner IncGroup PAC ID 1759380694, 6 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dickman Kettler & Bruner Inc

  • Optometrist
  • Coldwater, OH
  • NPI 1558478453
  Medicare reassignment Care Compare group NPD
• Aeg Ohio Professional PC

  • Optometrist
  • Solon, OH
  • NPI 1154980811
  Medicare reassignment NPD
• Aeg Ohio Professional PC

  dba Harper's Point

  • Optometrist
  • Cincinnati, OH
  • NPI 1932708047
  NPD
• Lima Memorial Joint Operating Company

  dba Lima Memorial Health System

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

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

{
    "created_epoch": "1675814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675814400000",
    "number": "1316644537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 BITTERSWEET DR",
            "city": "COLDWATER",
            "state": "OH",
            "postal_code": "458281402",
            "telephone_number": "419-953-2319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2155 ALLENTOWN RD",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458051705",
            "telephone_number": "419-228-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "CLARA",
        "middle_name": "DURIE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-08",
        "last_updated": "2023-02-08",
        "certification_date": "2023-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "OPT.007110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kavin Vrid
• Joe Wade
• Jordan Wade
• Joshua Wagenknecht, PA-C
• Ashley Marie Wagner, MOT, OTR/L
• Paige Wagner, MPH, RDN, LD
• William Wagner, DPM
• Ethan Wainblat, DO
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-3206)
• Wal-Mart Stores East LP (Walmart Pharmacy 10-1330)

• Optometrist in Lima, OH
• Providers in Lima, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 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.