Jere L Wagner, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD025370E Issued in PA

Practice address

2 N 8TH St
Shamokin, PA 17872-5607

Phone

(570) 644-1780

NPI assigned

Feb 7, 2006

Last updated

Jun 23, 2022By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

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.

• Geisinger Clinic

  • Family Medicine Physician
  • Danville, PA
  • NPI 1366493868
  Medicare reassignment NPD
• Geisinger Clinic

  • Diagnostic Radiology Physician
  • Danville, PA
  • NPI 1558313023
  NPD
• Geisinger Clinic

  • Family Medicine Physician
  • Pittston, PA
  • NPI 1578871083
  NPD
• Northeast Knee and Joint Institute, LLC.

  • Physical Medicine & Rehabilitation Physician
  • Dallas, PA
  • NPI 1689187072

  Family Medicine

  NPD (past)
• Northeast Knee and Joint Institute, LLC.

  • Physical Medicine & Rehabilitation Physician
  • Dallas, PA
  • NPI 1851871651
  NPD (past)

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655942400000",
    "number": "1730151358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 N 8TH ST",
            "city": "SHAMOKIN",
            "state": "PA",
            "postal_code": "178725607",
            "telephone_number": "570-644-1780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 N 8TH ST",
            "city": "SHAMOKIN",
            "state": "PA",
            "postal_code": "178725607",
            "telephone_number": "570-644-1780"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "460 River Ave",
            "address_purpose": "LOCATION",
            "city": "Williamsport",
            "state": "PA",
            "postal_code": "177013723",
            "country_code": "US",
            "telephone_number": "570-213-5221",
            "fax_number": "570-227-3316",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3832 Yalick Plaza Route 415",
            "address_2": "Unit 7",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "PA",
            "postal_code": "186127753",
            "country_code": "US",
            "telephone_number": "570-213-5221",
            "fax_number": "570-227-3316",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "JERE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD025370-E",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD025370E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victory Treatment Group LLC
• Vna Health System
• Vna Health System
• Vna Health System
• Vna Health System (Crossings Hospice)
• Joshua A Wagner, MS, LPC
• Wayne R Miller MD (Miller Family Health Center)
• Wayne R Miller MD (miller family health center)
• Weis Markets Inc (Weis Pharmacy)
• Jercora Witherspoon, PTA

• Family Medicine Physician in Shamokin, PA
• Providers in Shamokin, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2022; 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.