Alex Francis Wagner, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5101020032 Issued in MI

Practice address

6401 Prairie St
Suite 1600
Norton Shores, MI 49444-7840

Phone

(231) 727-7920

Fax

(231) 727-7921

NPI assigned

Jun 19, 2012

Sex

Male

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 MI

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

Family Practice

Education

Michigan State University College of Osteopathic Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mercy Physician NetworkGroup PAC ID 8921996307, 109 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trinity Health at Home - Muskegon Home health agency, Muskegon, MI, CCN 237198
• Trinity Health Muskegon Hospital Hospital, Muskegon, MI, CCN 230066
• Trinity Health Grand Haven Hospital Hospital, Grand Haven, MI, CCN 230174
• Spectrum Health Hospital, Grand Rapids, MI, CCN 230038

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/13864/brand/1/csg/1/fhir/r4

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.

• Mercy Physician Network

  • Family Medicine Physician
  • Muskegon, MI
  • NPI 1023056744
  Medicare reassignment Care Compare group NPD
• Mercy Physician Network

  • Family Medicine Physician
  • Fruitport, MI
  • NPI 1639502701
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mercy General Health Partners Amicare Homecare

  • Home Health Agency
  • Muskegon, MI
  • NPI 1063483972
  Care Compare affiliation
• Mercy Health Partners

  • General Acute Care Hospital
  • Muskegon, MI
  • NPI 1831132133
  Care Compare affiliation
• Pennock Hospital

  • Critical Access Hospital
  • Hastings, MI
  • NPI 1932695525
  Care Compare affiliation
• Spectrum Health Hospitals

  • General Acute Care Hospital
  • Grand Rapids, MI
  • NPI 1922090554
  Care Compare affiliation
• Trinity Health Grand Haven Hospital

  • General Acute Care Hospital
  • Grand Haven, MI
  • NPI 1942379284
  Care Compare affiliation

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

{
    "created_epoch": "1340064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451952000000",
    "number": "1952664583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 BROADWAY AVE NW APT 425",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495047324",
            "telephone_number": "989-387-5540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6401 PRAIRIE ST",
            "address_2": "SUITE 1600",
            "city": "NORTON SHORES",
            "state": "MI",
            "postal_code": "494447840",
            "telephone_number": "231-727-7920",
            "fax_number": "231-727-7921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "ALEX",
        "middle_name": "FRANCIS",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-19",
        "last_updated": "2016-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101020032",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE IND PTAN",
            "identifier": "N28430113",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hautumn Vangeison
• Jacob Vantimmeren
• Virginia Vazquez
• Barbara K Versalle, LLPC
• Vpa PC
• Jacquelyn Wagner, DPT
• Walgreen Co
• Shaunacy F Waller
• Alec Walstra
• Timothy S Wang, MD

• Family Medicine Physician in Norton Shores, MI
• Providers in Norton Shores, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2016; 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.