NPIMap

Organization Active NPI

James P. Vanwagner D.O., P.C.

  • Orthopaedic Surgery Physician
  • Traverse City, MI
National Provider Identifier
1669512000
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
JV009579 Issued in MI
Legal business name
JAMES P. VANWAGNER D.O., P.C.
Practice address
5246 N Royal Dr
Suite a
Traverse City, MI 49684-6984
Phone
(231) 935-0957
Fax
(231) 935-0960
NPI assigned
Feb 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. James Parker Vanwagner, D.O.
Title
Owner
Phone
(231) 935-0957

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X JV009579 MI Primary

Addresses

Primary practice location

5246 N Royal Dr
Suite a
Traverse City, MI 49684-6984

Mailing address

5246 N Royal Dr
Suite a
Traverse City, MI 49684-6984
Phone (231) 935-0957

National Provider Directory

National Provider Directory

Locations

5246 N Royal Dr
Ste A
Traverse City, MI 49684
Phone (231) 935-0957

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1669512000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5246 N ROYAL DR",
            "address_2": "SUITE A",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496846984",
            "telephone_number": "231-935-0957",
            "fax_number": "231-935-0960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5246 N ROYAL DR",
            "address_2": "SUITE A",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496846984",
            "telephone_number": "231-935-0957",
            "fax_number": "231-935-0960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES P. VANWAGNER D.O., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VANWAGNER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "PARKER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "231-935-0957",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "MI",
            "license": "JV009579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.