Katherine Mary Wagner, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

35-096862 Issued in OH

Practice address

13201 Granger Rd Ste 2
Garfield HTS, OH 44125-1979

Phone

(216) 475-8844

Fax

(216) 475-3816

NPI assigned

Jul 9, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: kwagner36022@ehrdirect.uhhospitals.org

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.

• University Primary Care Practices

  • Pediatrics Physician
  • Twinsburg, OH
  • NPI 1326166752
  NPD (past)

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

{
    "created_epoch": "1215561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324252800000",
    "number": "1396908265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24701 EUCLID AVE",
            "address_2": "3RD FLOOR",
            "city": "EUCLID",
            "state": "OH",
            "postal_code": "441171714",
            "telephone_number": "216-475-8844",
            "fax_number": "216-475-3816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13201 GRANGER RD STE 2",
            "city": "GARFIELD HTS",
            "state": "OH",
            "postal_code": "441251979",
            "telephone_number": "216-475-8844",
            "fax_number": "216-475-3816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "KATHERINE",
        "middle_name": "MARY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-09",
        "last_updated": "2011-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35-096862",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3149168",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dilip K Ujla, MD
• Union Eye Care Center, Inc. (Union Eye Care)
• University Primary Care Practices
• Cindy Ann Vanwagner, LPN
• Leah Velick, CNP
• Lakisha Nicole Walker, LPN
• T'Ien Miller Walker, R.N.
• Derrick Walters
• Alvin Derrell Wanzo
• Virginia Ward

• Pediatrics Physician in Garfield HTS, OH
• Providers in Garfield HTS, OH by specialty
• Pediatrics Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2011; 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.