Jessika Wagner, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

7719143-1205 Issued in UT

Practice address

4403 Harrison Blvd
Suite 4875
Ogden, UT 84403-3271

Phone

(801) 387-4500

NPI assigned

Oct 2, 2008

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 1

Medicare fee-for-service enrollment

Enrolled in UT

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Sandy, UT
  • NPI 1942325154
  Medicare reassignment NPD
• Ihc Health Services Inc

  • Cardiovascular Disease Physician
  • Ogden, UT
  • NPI 1457662587
  NPD
• Ihc Health Services, Inc.

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD
• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Orem, UT
  • NPI 1588601124
  NPD (past)

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

{
    "created_epoch": "1222905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289865600000",
    "number": "1922259449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128",
            "telephone_number": "801-387-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4403 HARRISON BLVD",
            "address_2": "SUITE 4875",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844033271",
            "telephone_number": "801-387-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "JESSIKA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-02",
        "last_updated": "2010-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "UT",
            "license": "7719143-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1922259449",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Tereese Voorhees
• Kevin Vore, MOTR/L
• Jocelyn Vranes
• Elizabeth Wade
• Charlotte Erin Wagner, RPH
• Jessica Susan Wagstaff, LAT, ATC
• Jack D Wahlen, M.D.
• Russell S. Wahlen, D.C.
• Norman O Wahlstrom Jr., MD
• Lara Waite, AUD

• Pediatrics Physician in Ogden, UT
• Providers in Ogden, UT by specialty
• Pediatrics Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2010; 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.