Jeffrey G Wagner, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

14017 Issued in NV

Practice address

9280 W Sunset Rd Ste 200
Las Vegas, NV 89148

Phone

(702) 844-4846

Fax

(702) 844-4847

NPI assigned

Jun 25, 2008

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 1

Medicare fee-for-service enrollment

Enrolled in NV, OR2 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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jeffrey.wagner.1@17520.direct.athenahealth.com

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.

• Bacchus PC

  dba P3 Health Partners Medical Group

  • Family Medicine Physician
  • Henderson, NV
  • NPI 1134628480
  Medicare reassignment NPD
• P3 Medical Group PC

  • Family Medicine Physician
  • Salem, OR
  • NPI 1689266926
  Medicare reassignment
• Healthcare Partners Medical Group Coats LTD

  • Family Medicine Physician
  • Las Vegas, NV
  • NPI 1487631917
  NPD

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

{
    "created_epoch": "1214352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638230400000",
    "number": "1568624187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 98978",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891938978",
            "telephone_number": "702-216-3346",
            "fax_number": "702-671-6883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9280 W SUNSET RD STE 200",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89148",
            "telephone_number": "702-844-4846",
            "fax_number": "702-844-4847"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5255 E Williams Cir Ste 3000",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857117407",
            "country_code": "US",
            "telephone_number": "520-393-3244",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2525 12th St SE Ste 260",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "OR",
            "postal_code": "973022282",
            "country_code": "US",
            "telephone_number": "971-701-9058",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "JEFFREY",
        "middle_name": "G",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-25",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "14017",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1568624187",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gerid Wagner
• Glaucia Marli Wagner, ARNP
• Hunter Wagner
• James Wagner
• James M Wagner, DDS
• Jennifer Wagner, CNM
• Katelyn Wagner
• Kathleen Therese Wagner, MD
• Maria Rebeca Wagner
• Olivia Leigh Wagner, RN

• Family Medicine Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Family Medicine Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2021; 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.