Andrea Wagner, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

21339-40 Issued in WI

Practice address

4518 Cottage Grove Rd
Madison, WI 53716-1206

Phone

(608) 222-3648

NPI assigned

Jul 18, 2022

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

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.

• Walgreen Co

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)

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

{
    "created_epoch": "1658102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658102400000",
    "number": "1447985080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10210 RUSTLING BIRCH RD APT 311",
            "city": "VERONA",
            "state": "WI",
            "postal_code": "535935141",
            "telephone_number": "763-331-5779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4518 COTTAGE GROVE RD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537161206",
            "telephone_number": "608-222-3648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "ANDREA",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-18",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "21339-40",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gabrielle E Waclawik, MD
• Cheryle S Wade, SAC-IT
• Michelle Raissa Kobou Wafo
• Joann M Wagner Novak, NP
• Amy Nicole Wagner, PA
• Annaliese O Wagner, DNP, FNP-C
• Casey Wagner, MA, SAC-IT
• Chad Martin Wagner, MD
• Danyon J. Wagner, M.D.
• Emilie Claire Wagner

• Pharmacist in Madison, WI
• Providers in Madison, WI by specialty
• Pharmacist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2022; 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.