Alex Wagner, LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

ALEX WAGNER, LLC

Practice address

1864 Lakeshore Dr Ste a
Muskegon, MI 49441-1607

Phone

(231) 755-1648

Fax

(231) 755-5279

NPI assigned

Sep 11, 2020

Last updated

Sep 15, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tracey Gable-Piper, CPC

Title

Office Manager

Phone

(231) 755-3647

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1599782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600128000000",
    "number": "1841805306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1864 LAKESHORE DR STE A",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494411607",
            "telephone_number": "231-755-1648",
            "fax_number": "231-755-5279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1864 LAKESHORE DR STE A",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494411607",
            "telephone_number": "231-755-1648",
            "fax_number": "231-755-5279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALEX WAGNER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-11",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-15",
        "status": "A",
        "authorized_official_last_name": "GABLE-PIPER",
        "authorized_official_first_name": "TRACEY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "231-755-3647",
        "authorized_official_credential": "CPC"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Daniel Alderink
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• Alejandro Nakahodo MD PC
• Courtney Alexander
• Eva Marie Alexander, RN
• Mitze Alexander, LMSW
• Katie M Alfredson
• Chmsalddin Alkhas, MD

• Primary Care Clinic/Center in Muskegon, MI
• Providers in Muskegon, MI by specialty
• Primary Care Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2020; 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.