Terry John Wagner, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

34006428 Issued in OH

Practice address

5655 Hudson Dr Ste 303
Hudson, OH 44236-4454

Phone

(330) 800-4800

Fax

(330) 653-3007

NPI assigned

Aug 9, 2005

Sex

Male

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 2

Medicare fee-for-service enrollment

Enrolled in OH

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

Family Practice

Education

Ohio University, College of Osteopathic Medicine, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hudson Family Practice, IncGroup PAC ID 8527113950, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Summa Home Health and Hospice LLC Home health agency, Akron, OH, CCN 367713
• Akron General Medical Center Hospital, Akron, OH, CCN 360027
• Summa Health System Hospital, Akron, OH, CCN 360020
• Summa Western Reserve Hospital Hospital, Cuyahoga Falls, OH, CCN 360150
• Cleveland Clinic Hospital, Cleveland, OH, CCN 360180

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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 and National Provider Directory roles.

• Hudson Family Practice, Inc

  • Family Medicine Physician
  • Hudson, OH
  • NPI 1063553980
  Medicare reassignment Care Compare group NPD Authorized official

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Akron General Medical Center

  • General Acute Care Hospital
  • Akron, OH
  • NPI 1821035940
  Care Compare affiliation
• Summa Health System

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Canton, OH
  • NPI 1295036762

  Hospital

  Care Compare affiliation
• Summa Health System

  • General Acute Care Hospital
  • Akron, OH
  • NPI 1396765681
  Care Compare affiliation
• Summa Health System

  • Clinical Medical Laboratory
  • Barberton, OH
  • NPI 1609263706

  Hospital

  Care Compare affiliation
• Summa Home Health and Hospice, LLC

  • Home Health Agency
  • Akron, OH
  • NPI 1013422534
  Care Compare affiliation
• The Cleveland Clinic Foundation

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1679525919
  Care Compare affiliation
• Western Reserve Hospital, LLC

  • General Acute Care Hospital
  • Cuyahoga Falls, OH
  • NPI 1518104199
  Care Compare affiliation

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580688000000",
    "number": "1679574834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5655 HUDSON DR STE 303",
            "city": "HUDSON",
            "state": "OH",
            "postal_code": "442364454",
            "telephone_number": "330-800-4800",
            "fax_number": "330-653-3007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5655 HUDSON DR STE 303",
            "city": "HUDSON",
            "state": "OH",
            "postal_code": "442364454",
            "telephone_number": "330-800-4800",
            "fax_number": "330-653-3007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "TERRY",
        "middle_name": "JOHN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2020-02-03",
        "certification_date": "2020-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34006428",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "0801451153",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2041543",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Hudson, OH
• Providers in Hudson, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2020; 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.