MARK ELLIOT WAGNER (NPI# 1033202502) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033202502 |
| Entity Type | Individual |
| Full Name | MARK ELLIOT WAGNER |
| Credential | D.O. |
| Practice Address |
623 North 5th Street Reading PA 19601 |
| Mailing Address |
623 N 5th St Reading PA 19601-2201 |
| Practice Telephone | 6103748585 |
| Practice Fax Number | 6103742574 |
| Mailing Telephone | 6103748585 |
| Mailing Fax Number | 6103742574 |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2020-02-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | OS005358-L | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 0966530 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528419074 | Mark Vincent Wagner | Dentist | 2600 Village Pkwy Ste 120, Highland Village, TX 75077-3285 | 2016-06-27 |
| 1467845487 | Mark Wagner | Health Educator | 600 Cornell Ave, Hagerstown, MD 21742-4500 | 2015-03-16 |
| 1265863112 | Mark Wagner | Dentist | 24 Old Plantation Way, Pikesville, MD 21208-6375 | 2013-12-03 |
| 1881967016 | Mark Allen Wagner | Physical Therapist | 4046 Arezzo Dr, Longmont, CO 80503-4157 | 2012-02-19 |
| 1780737924 | Mark Wagner | Psychologist | 23 Pokonoket Ave, Sudbury, MA 01776-2320 | 2007-01-19 |
| 1700821709 | Mark S Wagner | Psychiatry & Neurology | 515 Cabrillo Park Dr, Suite 120, Santa Ana, CA 92701-5016 | 2006-06-17 |
| 1649211764 | Mark David Wagner | Family Medicine | 1000 Dexter Ave N Ste 320, Seattle, WA 98109-4878 | 2006-06-09 |
| 1336130087 | Mark Andrew Wagner | Radiology | 2740 M St, Merced, CA 95340-2813 | 2005-11-02 |
| 1992358741 | Mark Wagner | Counselor | 540 Riverside Dr Ste 8, Salisbury, MD 21801-5352 | 2019-07-22 |
| 1134488752 | Mark E Wagner | Counselor | 900 W Norfolk Ave, Norfolk, NE 68701-5006 | 2012-05-16 |
| Street Address |
623 NORTH 5TH STREET |
| City | READING |
| State | PA |
| Zip Code | 19601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447754502 | Abilities In Motion | Case Manager/Care Coordinator | 210 North 5th Street, Reading, PA 19601 | 2018-03-22 |
| 1609390467 | Jenna Michele Sraiheen | Social Worker | 640 Walnut Street, Reading, PA 19601 | 2017-08-02 |
| 1295286615 | Chor Youth and Family Services | Residential Treatment Facility, Emotionally Disturbed Children | 1023 Pear Street, Reading, PA 19601 | 2016-10-20 |
| 1457802845 | Kimberly Reinert | Social Worker | 450 South Fifth Street, Reading, PA 19601 | 2016-10-20 |
| 1346598919 | William H Lord | Family Medicine | 624 Mercer St, Reading, PA 19601 | 2012-08-29 |
| 1902166119 | April Lynn Maletsky | Massage Therapist | 600 Centre Avenue, Reading, PA 19601 | 2012-05-22 |
| 1912235375 | Stephanie Elizabeth Rhudy | Physician Assistant | 101 West Bern St, Reading, PA 19601 | 2009-11-24 |
| 1740425099 | George J Chistakoff | Physician Assistant | 101 W Bern St, Hsc Bldg 22, Reading, PA 19601 | 2008-12-15 |
| 1841476496 | Annmarie Myers | Advanced Practice Midwife | 145 N 6th St, 2nd Fl, Reading, PA 19601 | 2008-01-14 |
| 1477765287 | Berks County Orthopedics | Chiropractor | 438 Walnut Street, 2nd Floor, Reading, PA 19601 | 2007-05-04 |
| Find all providers in zip 19601 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346598919 | William H Lord | Family Medicine | 624 Mercer St, Reading, PA 19601 | 2012-08-29 |
| 1316260649 | Harlan A Kutscher | Family Medicine | 16 Estates Dr, Reading, PA 19606-9595 | 2010-03-01 |
| 1184953598 | Martin Luther Spangler Jr. | Family Medicine | 1435 Museum Rd, Reading, PA 19610-2824 | 2009-12-14 |
| 1558532341 | Lazaro Pepen | Family Medicine | 40 S 5th St Frnt 1, Reading, PA 19602-1032 | 2008-03-19 |
| 1841470739 | Jose Sigfredo Subervi | Family Medicine | 111th South 5th Street, First Floor, Reading, PA 19602 | 2007-11-07 |
| 1467579599 | Gretchen Bybel | Family Medicine | 3701 Stoudts Ferry Bridge Rd, Reading, PA 19605-1338 | 2007-03-23 |
| 1386702413 | Reading Hospital | Family Medicine | 430 N 2nd St, Reading, PA 19601-2753 | 2006-12-04 |
| 1548332836 | Reading Convenient Care Inc | Family Medicine | 3535 N 5th Street Hwy, Reading Convenient Care, Reading, PA 19605 | 2006-11-14 |
| 1770664146 | Seema Kapadia Steel | Family Medicine | 146 N 6th St, Reading, PA 19601-3564 | 2006-10-18 |
| 1841386273 | Pamela Diane Murphy | Family Medicine | 623 N 5th St, Reading, PA 19601-2201 | 2006-10-05 |
| Find all providers in READING | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.