William Wright Wagnon

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

F2087 Issued in TX

Practice address

2801 S John Redditt Dr
Suite B
Lufkin, TX 75904-5666

Phone

(936) 632-6111

Fax

(936) 632-9182

NPI assigned

Oct 18, 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

Enrolled in TX

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

Ophthalmology

Education

University of Texas Medical Branch at Galveston, 1978

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

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 and National Provider Directory roles.

• William W Wagnon MD PA

  • Ophthalmology Physician
  • Lufkin, TX
  • NPI 1619192192
  Medicare reassignment NPD Authorized official
• William W Wagnon M D P a

  • Eyewear Supplier
  • Jasper, TX
  • NPI 1154687747
  NPD Authorized official

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320710400000",
    "number": "1902895345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 S JOHN REDDITT DR",
            "address_2": "SUITE B",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759045666",
            "telephone_number": "936-632-6111",
            "fax_number": "936-632-9182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 S JOHN REDDITT DR",
            "address_2": "SUITE B",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759045666",
            "telephone_number": "936-632-6111",
            "fax_number": "936-632-9182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNON",
        "first_name": "WILLIAM",
        "middle_name": "WRIGHT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-18",
        "last_updated": "2011-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "F2087",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "093898701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashli Rae Vinson, CCC/SLP
• Vivek Mangla, MD PC
• Andy Vo
• Dax Eli Wagner
• Jackson D Wagnon, M.D.
• Wal-Mart Stores Texas LLC
• Wal-Mart Stores Texas, LLC
• Wal-Mart Stores Texas, LLC.
• Walgreen Co
• Walgreen Co

• Ophthalmology Physician in Lufkin, TX
• Providers in Lufkin, TX by specialty
• Ophthalmology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2011; 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.