David Wagner, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

G55652 Issued in CA

Practice address

91 Gregory LN
Suite 15
Pleasant Hill, CA 94523-4981

Phone

(925) 685-0843

Fax

(925) 685-1899

NPI assigned

Jul 17, 2006

Last updated

Jun 21, 2012By 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dwagner8341@ehr.johnmuirhealth.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.

• John Muir Physician Network

  • General Practice Physician
  • Walnut Creek, CA
  • NPI 1841407665
  Medicare reassignment NPD
• John Muir Health

  • Rehabilitation Hospital Unit
  • Walnut Creek, CA
  • NPI 1447269303
  NPD (past)
• John Muir Health

  dba John Muir Health Medical Center, Concord Campus

  • General Acute Care Hospital
  • Concord, CA
  • NPI 1801821376
  NPD (past)

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340236800000",
    "number": "1700804077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT 34929",
            "address_2": "P.O. BOX 39000",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941390001",
            "telephone_number": "925-952-2828",
            "fax_number": "925-952-2850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91 GREGORY LN",
            "address_2": "SUITE 15",
            "city": "PLEASANT HILL",
            "state": "CA",
            "postal_code": "945234981",
            "telephone_number": "925-685-0843",
            "fax_number": "925-685-1899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2012-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G55652",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G556520",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angelique R. Von Halle, RN, NP
• Janessa Vreonis
• Yen Thi Vu, DDS
• Karen Vuong, MSN, APRN, CWOCN
• Robin L Wada
• Kathleen Wakim
• Walgreen Co (Walgreens #05864)
• Andrea Lynn Walker, M.F.T.
• Katherine Walker
• Robert T Wallace, MSN, RN, CNL, AMB-BC

• Pediatrics Physician in Pleasant Hill, CA
• Providers in Pleasant Hill, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.