Active NPI
William Michael Wagner, M.D.
- Emergency Medicine Physician
- Tripler Army Medical Center, HI
National Provider Identifier
1710154299
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- MD-17957
- Practice address
- 1 Jarrett White Rd
Tripler Army Medical Center, HI 96859-5001 - Phone
- (808) 433-3707
- NPI assigned
- May 13, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | MD-17957 | HI | Primary |
| Emergency Medicine Physician | 207P00000X | A128086 | CA |
Addresses
Primary practice location
1 Jarrett White Rd
Tripler Army Medical Center, HI 96859-5001
Mailing address
1 Jarrett White Rd
Tripler Army Medical Center, HI 96859-5001
Phone (808) 433-3707
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A128086 | CA | MD | Emergency Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210636800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1632182400000",
"number": "1710154299",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 JARRETT WHITE RD",
"city": "TRIPLER ARMY MEDICAL CENTER",
"state": "HI",
"postal_code": "968595001",
"telephone_number": "808-433-3707"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 JARRETT WHITE RD",
"city": "TRIPLER ARMY MEDICAL CENTER",
"state": "HI",
"postal_code": "968595001",
"telephone_number": "808-433-3707"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGNER",
"first_name": "WILLIAM",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-05-13",
"last_updated": "2021-09-21",
"certification_date": "2021-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "HI",
"license": "MD-17957",
"primary": true
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "CA",
"license": "A128086",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tripler Army Medical Center, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.