Active NPI
Karla Lee Wagner, M.D.
- Obstetrics & Gynecology Physician
- Lander, WY
National Provider Identifier
1942395652
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 5483A
- Practice address
- 745 Buena Vista Dr
Lander, WY 82520-3431 - Phone
- (307) 332-2941
- Fax
- (307) 332-2068
- NPI assigned
- Oct 4, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 5483A | WY | Primary |
Addresses
Primary practice location
745 Buena Vista Dr
Lander, WY 82520-3431
Mailing address
745 Buena Vista Dr
Lander, WY 82520-3431
Phone (307) 332-2941
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 306693 | Other | WY | BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5483A | WY | MD | Obstetrics & Gynecology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1942395652",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "745 BUENA VISTA DR",
"city": "LANDER",
"state": "WY",
"postal_code": "825203431",
"telephone_number": "307-332-2941",
"fax_number": "307-332-2068"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "745 BUENA VISTA DR",
"city": "LANDER",
"state": "WY",
"postal_code": "825203431",
"telephone_number": "307-332-2941",
"fax_number": "307-332-2068"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGNER",
"first_name": "KARLA",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "WY",
"license": "5483A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "306693",
"state": "WY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lander, WY
- Valley Dental
- Marisha Lee Vanvleet, APRN-CNP, PMHNP-BC
- Laura Varner, OTR/L, CHT
- Vince C. Irene, DC., PLLC (Family Chiropractic Center)
- Katarzyna Bernat Voorhies, LMT, RBP, NCTMB
- Walker Surgery and Endoscopy PC
- Elisabeth A Walkinshaw, OTR
- Rebecca Steele Wallingford
- Shannon Shay Watkins
- Mikel Robert Weideman, O.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.