Jennifer Wagner Inc

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA9101701 Issued in FL

Legal business name

JENNIFER WAGNER INC

Practice address

20201 NE 21St Ave
Miami, FL 33179-2804

Phone

(305) 987-4443

NPI assigned

Mar 24, 2015

Organization subpart

No

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

Authorized official

Name

Jennifer Wagner, PANPI 1609980093

Title

Owner

Phone

(305) 987-4443

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jennifer R Wagner, PA-C

  • Physician Assistant
  • Miami, FL
  • NPI 1609980093
  NPD (past) Authorized official

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

{
    "created_epoch": "1427155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427155200000",
    "number": "1467846956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20201 NE 21ST AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331792804",
            "telephone_number": "305-987-4443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20201 NE 21ST AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331792804",
            "telephone_number": "305-987-4443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNIFER WAGNER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-24",
        "last_updated": "2015-03-24",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-987-4443",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9101701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zenia M Jenkins, RN
• Jenmarie Medical Center Inc
• Jenn Medical Center Corp
• Jennifer Nardozzi LLC (FAB (Food and Body( Program)
• Jennifer Rosello Reyes, D.P.M., P.a.
• Jennifer's Pharmacy Discount Corp
• Chandra Miletta Jennings, D.O., MPH
• James Joseph Jennings, M.D.
• Karynna Emma Jennings, OTR/L
• Natalie Flexman Jennings

• Surgical Physician Assistant in Miami, FL
• Providers in Miami, FL by specialty
• Surgical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2015; 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.