Richard Wagner, M.D.

Primary specialty

Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X

License

J4594 Issued in TX

Practice address

2900 S Loop 256
Palestine, TX 75801-6958

Phone

(903) 731-1144

NPI assigned

May 18, 2006

Last updated

Apr 2, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in GA, OH2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: fmcrwagne@yourcarecommunity.org

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.

• Emergency Professional Services, Inc.

  dba Emergency Professional Services of Ohio, Inc.

  • Emergency Medicine Physician
  • Seaman, OH
  • NPI 1093762353
  Medicare reassignment NPD
• Phoebe Sumter Medical Center, Inc.

  • General Acute Care Hospital
  • Americus, GA
  • NPI 1609001312
  Medicare reassignment NPD
• Phoebe Sumter Medical Center, Inc

  dba Phoebe Sumter Ellaville Clinic

  • Rural Health Clinic/Center
  • Ellaville, GA
  • NPI 1376778001
  NPD
• DFW 501a Corporation

  • Anatomic Pathology & Clinical Pathology Physician
  • Carrollton, TX
  • NPI 1881665412
  NPD (past)
• Limestone Emergency PA

  • Emergency Medicine Physician
  • Mexia, TX
  • NPI 1588772420
  NPD (past)
• Texas East Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Palestine, TX
  • NPI 1679842082
  NPD (past)
• Traditions Emergency Medicine PA

  • Emergency Medical Services (Emergency Medicine) Physician
  • College Station, TX
  • NPI 1396786232
  NPD (past)

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712016000000",
    "number": "1881647956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 DRANE PL",
            "city": "CORSICANA",
            "state": "TX",
            "postal_code": "751102536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 S LOOP 256",
            "city": "PALESTINE",
            "state": "TX",
            "postal_code": "758016958",
            "telephone_number": "903-731-1144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "RICHARD",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35C.001377",
            "primary": false
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "TX",
            "license": "J4594",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "096949512",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "096949513",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Venable, PHARMD, RPH
• Dianna Vernon, LMT, NMT
• Travis Lee Wacha, FNP-BC, PMHNP-BC
• Gary M Waddell, M.D.
• Kelsee Wade, DC
• Wendy R Wagner, OTR
• Wal-Mart Stores Texas LLC (Walmart Pharmacy 10-0345)
• Wal-Mart Stores Texas, LP (Vision Center 30-0345)
• Walgreen Co (Walgreens #21478)
• Walgreen Co (Walgreens #09411)

• Emergency Medical Services (Emergency Medicine) Physician in Palestine, TX
• Providers in Palestine, TX by specialty
• Emergency Medical Services (Emergency Medicine) Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2024; 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.