Active NPI
David H Wagner, MD
- Emergency Medicine Physician
- Lexington, NC
National Provider Identifier
1730229634
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 26067
- Practice address
- 250 Hospital Dr
Lexington, NC 27292-6792 - Phone
- (336) 716-2255
- NPI assigned
- Feb 8, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 26067 | NC | Primary |
Addresses
Primary practice location
250 Hospital Dr
Lexington, NC 27292-6792
Mailing address
PO Box 344
Winston Salem, NC 27102-0344
Phone (336) 716-2255
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 891232T | Medicaid | NC |
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 |
|---|---|---|---|
| 26067 | NC | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1303257600000",
"number": "1730229634",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 344",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271020344",
"telephone_number": "336-716-2255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "250 HOSPITAL DR",
"city": "LEXINGTON",
"state": "NC",
"postal_code": "272926792",
"telephone_number": "336-716-2255"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGNER",
"first_name": "DAVID",
"middle_name": "H",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-08",
"last_updated": "2011-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "NC",
"license": "26067",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "891232T",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lexington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.