Active NPI
Kay E. Wagner, M.D.
- Diagnostic Radiology Physician
- Denver, CO
National Provider Identifier
1871687467
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 22636
- Practice address
- 938 Bannock St
Ste 300
Denver, CO 80204 - Phone
- (303) 914-8800
- Fax
- (303) 716-3777
- NPI assigned
- Oct 3, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 22636 | CO | Primary |
Addresses
Primary practice location
938 Bannock St
Ste 300
Denver, CO 80204
Mailing address
938 Bannock St
Ste 300
Denver, CO 80204
Phone (303) 914-8800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01226364 | Medicaid | CO |
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 |
|---|---|---|---|
| 22636 | CO | MD | Diagnostic Radiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1251676800000",
"number": "1871687467",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "938 BANNOCK ST",
"address_2": "STE 300",
"city": "DENVER",
"state": "CO",
"postal_code": "80204",
"telephone_number": "303-914-8800",
"fax_number": "303-716-3777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "938 BANNOCK ST",
"address_2": "STE 300",
"city": "DENVER",
"state": "CO",
"postal_code": "80204",
"telephone_number": "303-914-8800",
"fax_number": "303-716-3777"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGNER",
"first_name": "KAY",
"middle_name": "E.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-03",
"last_updated": "2009-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "CO",
"license": "22636",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01226364",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Denver, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.