Catherine Michelle Wagner, MD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

4351044093 Issued in MI

Practice address

1500 E Medical Center Drive, SPC 5856
FCVC 3Rd Floor, Reception C
Ann Arbor, MI 48109-5856

Phone

(734) 647-7321

Fax

(734) 362-5236

NPI assigned

Apr 25, 2019

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1556150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571702400000",
    "number": "1477117463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 E MEDICAL CENTER DRIVE",
            "address_2": "5344 CVC",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481095864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E MEDICAL CENTER DRIVE, SPC 5856",
            "address_2": "FCVC 3RD FLOOR, RECEPTION C",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481095856",
            "telephone_number": "734-647-7321",
            "fax_number": "734-362-5236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "CATHERINE",
        "middle_name": "MICHELLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-25",
        "last_updated": "2019-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4351044093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joleen Ann Wagner-Felkey, MSW
• Diane Penny Wagner-Heffner, MA
• Ashley Wagner, LMSW
• Benjamin Robert Wagner, MD
• Brandon Wagner
• Christine Carol Wagner, NP
• Christine E Wagner, PHARM.D.
• Emmarie Truman Wagner, LMSW
• Jessica Catherine Wagner, NP
• Kathryn A Wagner, PA

• Student in an Organized Health Care Education/Training Program in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Student in an Organized Health Care Education/Training Program in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2019; 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.