Eric Martin Wagner, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

9300 Dewitt Loop
Ft Belvoir, VA 22060-5285

Phone

(571) 231-3224

NPI assigned

Feb 15, 2012

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)

Not enrolled

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

{
    "created_epoch": "1329264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714089600000",
    "number": "1770856106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984310001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 DEWITT LOOP",
            "city": "FT BELVOIR",
            "state": "VA",
            "postal_code": "220605285",
            "telephone_number": "571-231-3224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "ERIC",
        "middle_name": "MARTIN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-15",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elaina Suzanne Virostko, RDN
• Thuthu Lieu Vo, R.PH
• Leslie Rachel Vojta, M.D.
• Karen M Vonderhaar, RD
• James Scott Wadding, D.O.
• Waler Reed Army Medical Center (Dewitt Army Hospital center)
• Caitlin E Walker, OTR/L, CHT
• Precious Jewel Walker, COTA
• Angela M Wallace, NP
• Tracey Lee Walsh-Chocolaad, PHARM.D., BCOP

• Physician Assistant in Ft Belvoir, VA
• Providers in Ft Belvoir, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2024; 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.