Haley Elyse Wagner, D.O.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

M2185 Issued in TX

Practice address

505 N Highway 77
Suite 200
Waxahachie, TX 75165-1128

Phone

(972) 923-1686

Fax

(972) 923-9268

NPI assigned

Jun 15, 2006

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

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in TX

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

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 and National Provider Directory roles.

• Healthtexas Provider Network

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1760488936

  Pediatrics

  Medicare reassignment NPD
• Healthtexas Provider Network

  dba Symmetry Anesthesia

  • Anesthesiology Physician
  • Lakeway, TX
  • NPI 1104714583
  NPD
• Healthtexas Provider Network

  • Family Medicine Physician
  • Flower Mound, TX
  • NPI 1427054402
  NPD
• Professional Emergency Physician Associates, LLC

  • Emergency Medicine Physician
  • Baton Rouge, LA
  • NPI 1992758247
  NPD (past)

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247097600000",
    "number": "1427092980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 N HIGHWAY 77",
            "address_2": "SUITE 200",
            "city": "WAXAHACHIE",
            "state": "TX",
            "postal_code": "751651128",
            "telephone_number": "972-923-1686",
            "fax_number": "972-923-9268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 N HIGHWAY 77",
            "address_2": "SUITE 200",
            "city": "WAXAHACHIE",
            "state": "TX",
            "postal_code": "751651128",
            "telephone_number": "972-923-1686",
            "fax_number": "972-923-9268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "HALEY",
        "middle_name": "ELYSE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-15",
        "last_updated": "2009-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "M2185",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1773210-02",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8BR069",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "177321003",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8F5194",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Duane F Vincent, D.C.
• Vineyard Home Health LLC
• Sheila Marie Vinson, NP
• Kim Vu, CNIM
• W. Griggs Dehay D.D.S., Inc.
• Victoria Elizabeth Wahlenmaier, DNP, APRN, FNP-BC
• Mary B Wainscott, CRNA, FNP-C
• Wal-Mart Stores Texas LLC (Walmart Pharmacy 10-0260)
• Wal-Mart Stores Texas, LP (Vision Center 30-0260)
• Dana Waldrip, HIS

• Pediatrics Physician in Waxahachie, TX
• Providers in Waxahachie, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.