Virginia Wagner, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

15100 Issued in SC

Practice address

3310 Magnolia St
Orangeburg, SC 29115-1466

Phone

(803) 531-6900

Fax

(803) 531-6907

NPI assigned

Jul 20, 2006

Last updated

Jul 9, 2007By the provider in NPPES

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

Enrolled in SC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Musc Community Physicians

  dba MUSC Community Physicians Specialty

  • Internal Medicine Physician
  • Bamberg, SC
  • NPI 1841878006
  Medicare reassignment NPD
• Musc Community Physicians

  dba MUSC Health Primary Care - Bowman

  • Rural Health Clinic/Center
  • Bowman, SC
  • NPI 1225735772
  NPD

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1588684609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3310 MAGNOLIA ST",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291151466",
            "telephone_number": "803-531-6900",
            "fax_number": "803-531-6907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3310 MAGNOLIA ST",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291151466",
            "telephone_number": "803-531-6900",
            "fax_number": "803-531-6907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "VIRGINIA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "15100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vein Center MD, LLC
• Qwashema Shaylnn Venable, MA
• Virexion Labs
• Adrena Camille Void
• Dennis Ray Wade I
• Wal-Mart Stores East LP (Walmart Pharmact 10-3724)
• Wal-Mart Stores East LP (Walmart Pharmacy 10-0616)
• Wal-Mart Stores East, LP (Vision Center 30-0616)
• Walgreen Co (Walgreens #09879)
• Walgreen Co (Walgreens #07506)

• Pediatrics Physician in Orangeburg, SC
• Providers in Orangeburg, SC by specialty
• Pediatrics Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.