David V Wagner, MD

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

29266 Issued in IA

Practice address

2730 Pierce St
Suite 204
Sioux City, IA 51104-3796

Phone

(712) 234-8787

Fax

(712) 234-8777

NPI assigned

Jan 25, 2006

Last updated

Apr 28, 2008By the provider in NPPES

Sex

Male

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 6

Medicare fee-for-service enrollment

Enrolled in IA, SD2 enrollments

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 2

Specialty

Otolaryngology

Education

University of Iowa, RJ & L Carver College of Medicine, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sanford Medical CenterGroup PAC ID 8325950215, 847 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Lukes Regional Medical Center Hospital, Sioux City, IA, CCN 160146
• Floyd Valley Healthcare Hospital, Le Mars, IA, CCN 161368

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://b99bfe22-cb9d-4128-ace6-6c2045dee050.gastro.prod.fhir.ema-api.com/fhir/r4/

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.

• David Van Wagner MD PC

  dba Wagner Ear, Nose & Throat

  • Otolaryngology Physician
  • Sioux City, IA
  • NPI 1194076349
  Medicare reassignment NPD Authorized official
• Sanford Medical Center

  dba Edith Sanford Breast Specialty Clinic

  • Family Medicine Physician
  • Sioux Falls, SD
  • NPI 1093090342
  Medicare reassignment Care Compare group NPD
• Northwest Iowa Hospital Corporation

  dba St. Luke's Regional Medical Center

  • Emergency Medical Services (Emergency Medicine) Physician
  • Sioux City, IA
  • NPI 1215962550

  Otolaryngology

  NPD (past)
• Pierce Street Same Day Surgery, LC

  • Ambulatory Surgical Clinic/Center
  • Sioux City, IA
  • NPI 1205030731
  NPD (past)
• St Lukes Health Resources

  dba St Lukes Imaging Center

  • Radiology Clinic/Center
  • Sioux City, IA
  • NPI 1457391849
  NPD (past)
• St Lukes Health Resources

  dba St Lukes Clinic Network

  • Family Medicine Physician
  • Sioux City, IA
  • NPI 1528001492

  Otolaryngology

  NPD (past)
• Winnebago Indian Health Service

  • General Acute Care Hospital
  • Winnebago, NE
  • NPI 1659392454
  NPD (past)

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

• Floyd Valley Healthcare

  • Critical Access Hospital
  • Le Mars, IA
  • NPI 1326109315
  Care Compare affiliation
• Northwest Iowa Hospital Corporation

  dba St Lukes Regional Medical Center

  • General Acute Care Hospital
  • Sioux City, IA
  • NPI 1962594622
  Care Compare affiliation

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209340800000",
    "number": "1508836123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2730 PIERCE ST",
            "address_2": "SUITE 204",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511043796",
            "telephone_number": "712-234-8787",
            "fax_number": "712-234-8777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2730 PIERCE ST",
            "address_2": "SUITE 204",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511043796",
            "telephone_number": "712-234-8787",
            "fax_number": "712-234-8777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "DAVID",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-25",
        "last_updated": "2008-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IA",
            "license": "29266",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00365203",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3111864",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BCBS OF IOWA",
            "identifier": "28672",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7771514",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS  CHOICE",
            "identifier": "1799",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025458200",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary J Vontersch Hanno, MSW LISW
• Pat Wabashaw
• Michael G Wadzinski, M.D.
• Wagner Chiropractic
• Wagner Chiropractic P.C.
• Hailey Wagner
• Jason Leigh Wagner, L.M.H.C.
• Kelly Jean Wagner, LMHC
• Wagner, Kuntz & Grabouski
• Richard W Wagner Jr., DDS MS

• Otolaryngology Physician in Sioux City, IA
• Providers in Sioux City, IA by specialty
• Otolaryngology Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2008; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.