Individual provider Active NPI

Donna RM Wagner, M.D.

  • Anesthesiology Physician
  • Victoria, TX
National Provider Identifier
1487743969
Registry record updated Oct 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
J0338 Issued in TX
Practice address
2701 Hospital Dr
Victoria, TX 77901-5749
Phone
(361) 573-9181
NPI assigned
Oct 12, 2006
Last updated
Oct 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X J0338 TX Primary

Addresses

Primary practice location

2701 Hospital Dr
Victoria, TX 77901-5749

Mailing address

2701 Hospital Dr
Victoria, TX 77901-5749
Phone (361) 573-9181

Other practice location 1

6404 Nursery Dr Ste 300
Victoria, TX 77904-1688
Phone (361) 570-8311

Other practice location 2

815 N Virginia St
Port Lavaca, TX 77979-3025
Phone (361) 552-6713

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20120213000191 TX Practitioner - Anesthesiology 1557353117 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Baylor College of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Citizens Medical Center County of VictoriaGroup PAC ID 3577785096, 102 clinicians

Practice addresses (Care Compare)

2701 Hospital Dr
Victoria, TX 77901-5749
Phone (361) 573-9181

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Citizen's Medical Center County of Victoria Anesthesiology CurrentSince Apr 1, 2022 Accepting new patients
Citizens Medical Center County of Victoria Past Accepting new patients

Locations

815 N Virginia St
Port Lavaca, TX 77979
Phone (361) 552-0325

2701 Hospital Dr
Victoria, TX 77901
Phone (361) 573-9180

2701 Hospital Dr
Fl 6
Victoria, TX 77901
Phone (361) 572-5113

4406 N Laurent St
Victoria, TX 77901
Phone (361) 578-0107

6404 Nursery Dr
Ste 300
Victoria, TX 77904
Phone (361) 570-8311

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1487743969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 HOSPITAL DR",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779015749",
            "telephone_number": "361-573-9181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 HOSPITAL DR",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779015749",
            "telephone_number": "361-573-9181"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6404 Nursery Dr Ste 300",
            "address_purpose": "LOCATION",
            "city": "Victoria",
            "state": "TX",
            "postal_code": "779041688",
            "country_code": "US",
            "telephone_number": "361-570-8311",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "815 N Virginia St",
            "address_purpose": "LOCATION",
            "city": "Port Lavaca",
            "state": "TX",
            "postal_code": "779793025",
            "country_code": "US",
            "telephone_number": "361-552-6713",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "DONNA",
        "middle_name": "RM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "J0338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Victoria, TX

Sources for this page

Verify at the official NPI Registry.