MATTHEW WAGNER (NPI# 1053785840) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053785840 |
| Entity Type | Individual |
| Full Name | MATTHEW WAGNER |
| Practice Address |
1200 Grant Blvd W Wabasha MN 55981 |
| Mailing Address |
1200 Grant Blvd W Wabasha MN 55981-1042 |
| Practice Telephone | 6515655600 |
| Mailing Telephone | 6515655600 |
| Enumeration Date | 2015-11-17 |
| Last Update Date | 2018-11-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | R 170201-9 | MN | Nursing Service Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
CNP 4307 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | APRN LICENSE | CNP 4307 | 01 |
| MN | RN LICENSE | R 170201-9 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 210 9th St Se, Rochester, MN 559046756 | 5072883443 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578052866 | Matthew Robert Wagner | Dentist | 2830 Curry Ln #1, Green Bay, WI 54311 | 2018-05-02 |
| 1538534334 | Matthew Wagner | Acupuncturist | 4513 Vernon Blvd, Madison, WI 53705-4993 | 2015-12-04 |
| 1053749168 | Matthew Wagner | Counselor | 545 N Mcdonough St Ste 212, Decatur, GA 30030-3310 | 2013-10-29 |
| 1114198751 | Matthew Robert Wagner | Orthopaedic Surgery | 1500 Route 112 Bldg 2c, Port Jefferson Station, NY 11776-8055 | 2008-03-21 |
| 1700415965 | Matthew Anthony Wagner | Student in an Organized Health Care Education/Training Program | 1500 E Sherman Blvd, Muskegon, MI 49444-1849 | 2020-04-08 |
| 1376177048 | Matthew Gary Wagner | Case Manager/Care Coordinator | 16 W Long St, Columbus, OH 43215-2815 | 2020-03-02 |
| 1235613738 | Matthew James Wagner | Pharmacist | 17213 Cole Rd, Hagerstown, MD 21740-6981 | 2018-09-20 |
| 1164918199 | Matthew Steven Wagner | Internal Medicine | 5225 23rd Ave S, Fargo, ND 58104-7927 | 2018-07-02 |
| 1609371244 | Matthew Anthony Wagner | Student in an Organized Health Care Education/Training Program | 509 Biltmore Ave, Asheville, NC 28801-4601 | 2018-03-26 |
| 1669994752 | Matthew Wagner | Behavior Technician | 415 Medical Dr Ste D101, Bountiful, UT 84010-8905 | 2017-07-11 |
| Street Address |
1200 GRANT BLVD W |
| City | WABASHA |
| State | MN |
| Zip Code | 55981 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659355600 | Saint Elizabeths Hospital of Wabasha Inc | Clinical Medical Laboratory | 1200 Grant Blvd W, Wabasha, MN 55981-1098 | 2005-12-02 |
| 1851858112 | Paula Kae Thompson | Dietitian, Registered | 1200 Grant Blvd W, Wabasha, MN 55981-1042 | 2019-02-22 |
| 1245727056 | Malinda Jean Wise | Social Worker | 1200 Grant Blvd W, Wabasha, MN 55981 | 2018-04-17 |
| 1376047431 | Brady Ritscher | Pharmacist | 1200 Grant Blvd W, Wabasha, MN 55981-1042 | 2018-03-22 |
| 1477068914 | Saint Elizabeths Hospital of Wabasha Inc | Clinic/Center | 1200 Grant Blvd W, Wabasha, MN 55981-1042 | 2017-12-06 |
| 1851819163 | Carol Ann Groth | Occupational Therapy Assistant | 1200 Grant Blvd W, Wabasha, MN 55981-1042 | 2017-09-07 |
| 1073050274 | Saint Elizabeths Hospital of Wabasha Inc | Clinic/Center | 1200 Grant Blvd W, Wabasha, MN 55981-1042 | 2017-01-25 |
| 1164977880 | Elizabeth Nofsinger | Physical Therapist | 1200 Grant Blvd W, Wabasha, MN 55981-1042 | 2016-08-23 |
| 1518339415 | Ryan Randy Reidt | Physical Therapist | 1200 Grant Blvd W, Wabasha, MN 55981-1042 | 2015-10-30 |
| 1912334913 | St. Elizabeth's Outpatient Pharmacy | Pharmacy | 1200 Grant Blvd W, Wabasha, MN 55981-1042 | 2013-10-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396266003 | Lc Edelbach Company LLC | Pharmacy | 160 Main Street West, Wabasha, MN 55981 | 2017-07-03 |
| 1154372217 | Robert James Mann | Dentist | 115 E Main Street, Wabasha, MN 55981 | 2006-05-13 |
| 1447772249 | Katlyn Jo Jessen | Counselor | 611 Broadway Ave Ste 100, Wabasha, MN 55981 | 2017-07-13 |
| 1760783492 | Anna Emily Battcher | Pharmacist | 1200 5th Grant Blvd, Wabasha, MN 55981-1042 | 2010-11-11 |
| 1679636393 | Ursula I Miller | Family Medicine | 1202 Grant Blvd W, Wabasha, MN 55981-1042 | 2006-12-18 |
| 1437139730 | Marc J. Hampl | Physician Assistant | 1202 5th Grant Blvd, Wabasha, MN 55981-1042 | 2006-01-20 |
| 1184720567 | Fred Mcrae Roberson | Family Medicine | 1202 5th Grant Blvd, Lake City Medical Center, Wabasha, MN 55981-1042 | 2006-09-15 |
| 1316980907 | Mark Wayne Bingham | Physician Assistant | 1202 5th Grant Blvd, Wabasha, MN 55981-1042 | 2006-06-13 |
| 1558331090 | Valerie D. Mcgrath | Physician Assistant | 1202 5th Grant Blvd, Wabasha, MN 55981-1042 | 2006-01-26 |
| 1659341212 | Brian E. Kelly | Family Medicine | 1202 5th Grant Blvd, Wabasha, MN 55981-1042 | 2006-01-25 |
| Find all providers in zip 55981 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861462418 | Rebecca S. Nelson | Nurse Practitioner | 1202 5th Grant Blvd, Wabasha, MN 55981-1042 | 2006-01-25 |
| 1902876808 | Sharon Riester | Nurse Practitioner | 1200 Grant Blvd W, Wabasha, MN 55981-1042 | 2006-01-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508466368 | Amalia Jo Folland Harvey | Nurse Practitioner | 19883 Evensong Ct, Farmington, MN 55024-8688 | 2020-10-29 |
| 1710586235 | Jackelyn Laura Peterson | Nurse Practitioner | 10101 Bren Rd E Unit 345, Minnetonka, MN 55343-0060 | 2020-10-26 |
| 1578162509 | Mckenzie Mcadaragh | Nurse Practitioner | 10924 Girard Curve, Bloomington, MN 55431 | 2020-10-21 |
| 1861091704 | Morgan Rohl | Nurse Practitioner | 117 12th Ave Nw Apt 2, Rochester, MN 55901-2787 | 2020-10-21 |
| 1063010304 | Kalie R Mccauley | Nurse Practitioner | 11452 Brook Rd Nw, Elk River, MN 55330-8739 | 2020-10-09 |
| 1659978930 | Sarah Jean Mudge | Nurse Practitioner | 350 Harbor Dr, Duluth, MN 55802-2600 | 2020-10-08 |
| 1285231621 | Karlu Dorleh | Nurse Practitioner | 14151 Territorial Rd Unit 212, Maple Grove, MN 55369-5725 | 2020-10-08 |
| 1447857669 | Kimberly Dawn Bursch-tewalt | Nurse Practitioner | 11884 237th Ave Nw, Elk River, MN 55330-8255 | 2020-10-01 |
| 1639786312 | Peter Wahl | Nurse Practitioner | 4652 Lyndale Ave S, Minneapolis, MN 55419-5302 | 2020-09-28 |
| 1568078616 | Joanna Kay Rehm | Nurse Practitioner | 3025 Eagandale Pl Apt 338, Eagan, MN 55121-1236 | 2020-09-23 |
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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.