Lois Wagstrom, M.D.

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

MD021252 Issued in TN

Practice address

310 23Rd Ave N
Ste. 100
Nashville, TN 37203-1525

Phone

(615) 329-1822

NPI assigned

May 25, 2006

Last updated

Jun 13, 2012By the provider in NPPES

Sex

Female

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

Enrolled in TN

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 1

Specialty

Plastic and Reconstructive Surgery

Education

Other, 1981

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Lois Wagstrom M.D., P.C.

  • Plastic and Reconstructive Surgery Physician
  • Nashville, TN
  • NPI 1265694376
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339545600000",
    "number": "1902852544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 23RD AVE N",
            "address_2": "STE. 100",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372031525",
            "telephone_number": "615-329-1822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 23RD AVE N",
            "address_2": "STE. 100",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372031525",
            "telephone_number": "615-329-1822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGSTROM",
        "first_name": "LOIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-25",
        "last_updated": "2012-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "TN",
            "license": "MD021252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Krystn Rae Wagner, MD
• Rachel L Wagner, ARNP
• Whitney Wagner, RD, LD
• Julianne Wagnon, APRN
• Katie Wagstaffe, NP
• Rifat A Wahab, DO
• John Wahba, NP-C
• Ahmed Wahbe, MD
• Iqra Wahid, OD
• Zia U Wahid, MD

• Plastic and Reconstructive Surgery Physician in Nashville, TN
• Providers in Nashville, TN by specialty
• Plastic and Reconstructive Surgery Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2012; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.