Patrick A Wagner, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

20010493A Issued in IN

Practice address

8424 Naab Rd Ste 1L
Indianapolis, IN 46260-1954

Phone

(317) 338-7780

NPI assigned

Jul 8, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Medical Psychology Associates, PC

  • Psychologist
  • Fishers, IN
  • NPI 1366449043
  NPD (past)
• Medpsych Consultants PC

  • Clinical Psychologist
  • MC Cordsville, IN
  • NPI 1447585823
  NPD (past)
• St. Vincent Hospital & Health Care Center, Inc.

  • Community/Retail Pharmacy
  • Indianapolis, IN
  • NPI 1194929646
  NPD (past)
• St. Vincent Hospital & Health Care Center, Inc.

  • Psychiatry Physician
  • Indianapolis, IN
  • NPI 1689869893

  Psychologist

  NPD (past)

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

{
    "created_epoch": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662595200000",
    "number": "1902804446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8424 NAAB RD STE 1L",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8424 NAAB RD STE 1L",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601954",
            "telephone_number": "317-338-7780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "PATRICK",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-08",
        "last_updated": "2022-09-08",
        "certification_date": "2022-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IN",
            "license": "20010493A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100073410",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John F Wagner, MD
• Karyn Elizabeth Wagner
• Keelie Madison Wagner, APRN, CPNP-PC
• Megan Theresa Wagner
• Monica Wagner
• Samantha Louise Wagner, M.D.
• Susan Elaine Wagner, DDS
• Whitney Wagner, NP-C
• Yen T Wagner, DDS
• Zachary Cole Wagner, DO

• Psychologist in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Psychologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2022; 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.