Mark Stephen Wagner, MD

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

31391 Issued in SC

Practice address

298 Memorial Dr
Seneca, SC 29672-9443

Phone

(864) 885-7758

Fax

(864) 885-7749

NPI assigned

Feb 8, 2006

Last updated

May 20, 2019By 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Wagner Medical Associates

  • Internal Medicine Physician
  • Highlands, NC
  • NPI 1134291347
  NPD (past) Authorized official

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

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558310400000",
    "number": "1336112614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 INDEPENDENCE PT STE 212",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154536",
            "telephone_number": "864-797-6306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "298 MEMORIAL DR",
            "city": "SENECA",
            "state": "SC",
            "postal_code": "296729443",
            "telephone_number": "864-885-7758",
            "fax_number": "864-885-7749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "MARK",
        "middle_name": "STEPHEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-08",
        "last_updated": "2019-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "31391",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "SC",
            "license": "31391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nelson Vazquez, OT
• Victory Spinal Care Clemson LLC
• Joyce Vissage, CPNP
• Kaci Brooke Wagler, FNP-C
• Lindsey Wagner
• Wal-Mart Stores East LP (Walmart Pharmacy 10-1123)
• Wal-Mart Stores East, LP (Vision Center 30-1123)
• Meredith Taylor Waldrop, FNP-C
• Stephanie Hequembourg Waldrop, MD
• Walgreen Co (Walgreens #10163)

• Hospitalist Physician in Seneca, SC
• Providers in Seneca, SC by specialty
• Hospitalist Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.