Richard W. Wagner, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC2419 Issued in FL

Practice address

218 N Main St (US 19)
Chiefland, FL 32626

Phone

(352) 493-4448

Fax

(352) 490-8100

NPI assigned

May 17, 2006

Last updated

Sep 11, 2018By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Richard Wagner , OD,PA

  • Optometrist
  • Chiefland, FL
  • NPI 1598980435
  Authorized official Same address or phone
• Gainesville Eye Physicians PA

  • Ophthalmology Physician
  • Gainesville, FL
  • NPI 1992846471
  NPD (past)
• Pensacola Vision Center Inc

  • Optometrist
  • Pensacola, FL
  • NPI 1649529439
  NPD (past)

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536624000000",
    "number": "1689626582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 2622",
            "city": "CHIEFLAND",
            "state": "FL",
            "postal_code": "32644",
            "telephone_number": "135-249-3444",
            "fax_number": "135-249-0810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 N MAIN ST (US 19)",
            "city": "CHIEFLAND",
            "state": "FL",
            "postal_code": "32626",
            "telephone_number": "352-493-4448",
            "fax_number": "352-490-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "RICHARD",
        "middle_name": "W.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2018-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC2419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carmen A. Tozzo, PHD
• Trenton Medical Center Inc (Palms Medical Group)
• Trenton Medical Center, Inc. (Palms Pharmacy of Chiefland)
• Kiambe B Tunsil
• Mary Ellen Valletta, MD
• Wal-Mart Stores East LP (Walmart Pharmacy 10-1297)
• Wal-Mart Stores East, LP (Vision Center 30-1297)
• Walgreen Co. (Walgreens #09787)
• Ashley B Watson, LCSW
• We Scan Diagnostics LLC

• Optometrist in Chiefland, FL
• Providers in Chiefland, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2018; 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.