Wayne T Hagerman OD PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

AK055 Issued in AK

Legal business name

WAYNE T HAGERMAN OD PC

Practice address

700 Katlian St Ste C
Sitka, AK 99835-7314

Phone

(907) 747-6644

Fax

(907) 747-4990

NPI assigned

May 14, 2010

Organization subpart

No

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

Authorized official

Name

Greta L Ryan

Title

Clerk

Phone

(907) 747-6644

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AK

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Natalie Esilda Macke, OD

  • Optometrist
  • Fairbanks, AK
  • NPI 1487921748
  Medicare reassignment NPD

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

{
    "created_epoch": "1273795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312329600000",
    "number": "1578881561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 KATLIAN ST STE C",
            "city": "SITKA",
            "state": "AK",
            "postal_code": "998357314",
            "telephone_number": "907-747-6644",
            "fax_number": "907-747-4990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 KATLIAN ST STE C",
            "city": "SITKA",
            "state": "AK",
            "postal_code": "998357314",
            "telephone_number": "907-747-6644",
            "fax_number": "907-747-4990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAYNE T HAGERMAN OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-14",
        "last_updated": "2011-08-03",
        "status": "A",
        "authorized_official_last_name": "RYAN",
        "authorized_official_first_name": "GRETA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CLERK",
        "authorized_official_telephone_number": "907-747-6644"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "AK",
            "license": "AK055",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OP0055",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AK55",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chris Washko
• Ian Waskey
• Mary Lynn Watkins, RN
• Chandra Brianne Watson
• Donna Watts, RN
• John Welsh
• Dale Lloyd Welty
• Melissa Wentzel
• April Lynn West
• Kyla F Westcott, CHP

• Optometrist in Sitka, AK
• Providers in Sitka, AK by specialty
• Optometrist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.