Sandra M Wagner, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

617-023 Issued in WI

Practice address

101 Manning Dr
Chapel Hill, NC 27514

Phone

(919) 966-4431

NPI assigned

Jun 23, 2006

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: swagner527079@direct.unc.nchie.net

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.

• University of North Carolina at Chapel Hill

  • Anesthesiology Physician
  • Chapel Hill, NC
  • NPI 1780669200
  Medicare reassignment NPD
• University of North Carolina at Chapel Hill

  • Family Medicine Physician
  • Raleigh, NC
  • NPI 1972912285
  NPD

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551830400000",
    "number": "1922034875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 VILLAGE CROSSING DR",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "27517",
            "telephone_number": "608-332-9404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MANNING DR",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "27514",
            "telephone_number": "919-966-4431"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10 Tower Dr",
            "address_purpose": "LOCATION",
            "city": "Sun Prairie",
            "state": "WI",
            "postal_code": "535901239",
            "country_code": "US",
            "telephone_number": "608-825-3008",
            "fax_number": "608-825-3786",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10 Tower Dr",
            "address_purpose": "LOCATION",
            "city": "Sun Prairie",
            "state": "WI",
            "postal_code": "535901239",
            "country_code": "US",
            "telephone_number": "608-825-3008",
            "fax_number": "608-825-3786",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "SANDRA",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-23",
        "last_updated": "2019-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "617-023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEAN HEALTH INSURANCE",
            "identifier": "2292",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42935000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• George Lane Wagaman Jr., ED.D.
• Bonnie Alexander Wagner, PA-C, RDN
• Jeanne Wagner, LCSW
• Jolynn Marie Wagner, DPT
• Richard W Wagner Jr., DMD
• Shaun R. Wagner, D.O.
• Sibyl Maureen Wagner, MSW, LCSW
• Andrew Johnston Wagoner, D.D.S
• Joel M Wagoner, DDS
• Karlee Crumpton Wagoner, APRN-BC

• Physician Assistant in Chapel Hill, NC
• Providers in Chapel Hill, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2019; 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.