Individual provider Active NPI

Brett D Wagner, D.O.

  • Emergency Medicine Physician
  • Lancaster, SC
National Provider Identifier
1982658241
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
538 Issued in SC
Practice address
800 W Meeting St
Lancaster, SC 29720-2202
Phone
(803) 286-1479
Fax
(803) 286-1369
NPI assigned
May 20, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 538 SC Primary

Addresses

Primary practice location

800 W Meeting St
Lancaster, SC 29720-2202

Mailing address

8000 Rocky View Rd
Belmont, NC 28012-6740
Phone (704) 266-4179

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031125000582 NC Practitioner - Emergency Medicine 1557265089 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

201 E Grover St
Shelby, NC 28150-3917
Phone (704) 487-3131

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Emergency Physicians, P.a. Emergency Medicine CurrentSince Dec 3, 2012 Accepting new patients
Carolinas Emergency Physicians, P.a. Emergency Medicine CurrentSince Dec 3, 2012 Accepting new patients
Emergency Medicine Physicians of Gaston County, PLLC Emergency Medicine Past Accepting new patients
Emergency Medicine Physicians of Craven County, PLLC Emergency Medicine Past Accepting new patients
Wren Emergency Physicians Emergency Medicine Past Accepting new patients
Emergency Medicine Physicians of Cortland County, PLLC Emergency Medicine Past Accepting new patients
Sterling Emergency Services of the Southeast, Inc Emergency Medicine Past Accepting new patients
South Carolina Em-I Medical Services, PC Emergency Medicine Past Accepting new patients
Emergency Physician Specialists Inc Emergency Medicine Past Accepting new patients
Linville Emergency Physicians PLLC Emergency Medicine Past Accepting new patients

Locations

706 W King St
Kings Mtn, NC 28086
Phone (704) 730-5108

201 E Grover St
Shelby, NC 28150
Phone (704) 487-3000

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1982658241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8000 ROCKY VIEW RD",
            "city": "BELMONT",
            "state": "NC",
            "postal_code": "280126740",
            "telephone_number": "704-266-4179",
            "fax_number": "727-507-3618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W MEETING ST",
            "city": "LANCASTER",
            "state": "SC",
            "postal_code": "297202202",
            "telephone_number": "803-286-1479",
            "fax_number": "803-286-1369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "BRETT",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": "538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, SC

Sources for this page

Verify at the official NPI Registry.