Kathryn A Wagner, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

J0875 Issued in TX

Practice address

414 Navarro St
Ste 1407
San Antonio, TX 78205-2516

Phone

(210) 277-6255

Fax

(210) 277-6256

NPI assigned

Feb 14, 2006

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

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Interoperability endpoints

• Direct secure messaging: kathryn.wagner@txo.ikm.direct-ci.com

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454025600000",
    "number": "1679547046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 911230",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753911230",
            "telephone_number": "972-997-8000",
            "fax_number": "972-234-2987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 NAVARRO ST",
            "address_2": "STE 1407",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782052516",
            "telephone_number": "210-277-6255",
            "fax_number": "210-277-6256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "KATHRYN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-14",
        "last_updated": "2016-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "J0875",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01547654",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "089953601",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "089953605",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chelsea Jo A Wagner
• Gail Wagner
• Hannah Wagner
• Jill Wagner
• Kailan Wagner
• Rebecca Wagner, PA
• Sara Elida Wagner, CCC-SLP
• Sydney J Wagner, LPC-A
• Timothy Downey Wagner, MD, MBA
• Cassandra Wagoner, PT, DPT

• Surgery Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2016; 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.