Laura Ella Wagner, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

R8N01 Issued in MO

Practice address

14377 Woodlake Dr
Suite 111
Chesterfield, MO 63017-5735

Phone

(314) 434-1111

Fax

(314) 434-1112

NPI assigned

Feb 8, 2006

Last updated

May 24, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in MO

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

Specialty

Dermatology

Education

Washington University School of Medicine, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

94.49 of 100Reported as individual

Quality

91.08

Promoting interoperability

98

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14699/brand/1/csg/1/fhir/r4
• FHIR API: https://fhir4.healow.com/fhir/r4/IEIBBD
• FHIR API: https://fhir4.healow.com/fhir/r4/IEIBBD/Endpoint/IEIBBD
• Direct secure messaging: laura.wagner@lwi.eclinicaldirectplus.com

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.

• Laura Wagner Inc

  • Dermatology Physician
  • Town and Country, MO
  • NPI 1194956276
  Medicare reassignment NPD Authorized official
• Laura Wagner, Inc

  • Specialist
  • Saint Peters, MO
  • NPI 1487801635
  NPD (past) Authorized official
• Varicose Vein Center of St Louis, Inc

  dba The Vein Center & CosMed

  • Specialist
  • Saint Louis, MO
  • NPI 1992996821
  NPD (past)

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

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337817600000",
    "number": "1669445060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14377 WOODLAKE DR",
            "address_2": "SUITE 111",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630175735",
            "telephone_number": "314-434-1111",
            "fax_number": "314-434-1112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14377 WOODLAKE DR",
            "address_2": "SUITE 111",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630175735",
            "telephone_number": "314-434-1111",
            "fax_number": "314-434-1112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "LAURA",
        "middle_name": "ELLA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-08",
        "last_updated": "2012-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MO",
            "license": "R8N01",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID#",
            "identifier": "431895147",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSMO PROVIDER #",
            "identifier": "18374",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK ID#",
            "identifier": "211386",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHP PROVIDER #",
            "identifier": "39228V39228",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER #",
            "identifier": "4420124",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa Allison Wachler, CCC-SLP
• Jacob Patrick Wacker, MMSC, PA-C
• Courtney Ann Wagner, PA-C
• Daniel Gray Wagner, M.D.
• Deborah E Wagner, PA-C
• Salman Waheed, M.D., M.P.H.
• Wahl Health & Wellness LLC (Wahl Family Chiropractic)
• Aaron Wahl, D.C.
• Kimberly Wahl, FNP-BC
• Pamela J Wakefield, D.C.

• Specialist in Chesterfield, MO
• Providers in Chesterfield, MO by specialty
• Specialist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2012; 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.