DR. DENNIS E WAGNER (NPI# 1184649402) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184649402 |
| Entity Type | Individual |
| Full Name | DR. DENNIS E WAGNER |
| Credential | ED.D. |
| Practice Address |
1169 Eastern Pkwy Ste 2238 Louisville KY 40217-1444 |
| Mailing Address |
1806 Richmond Dr Louisville KY 40205-1410 |
| Practice Telephone | 5027189114 |
| Practice Fax Number | 5024793561 |
| Mailing Telephone | (502) 718-9114 |
| Mailing Fax Number | 5024793561 |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2017-09-01 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
128987 | KY | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
0810 | KY | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 89008106 | 05 | |
| KY | ANTHEM | 000000501117 | 01 |
| KY | MEDICARE | K113410 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982803920 | Dennis Ryan Wagner | Dentist | 407 South 48th St, Quincy, IL 62305 | 2007-07-11 |
| 1285850347 | Dennis Michael Wagner | Pharmacist | 79 Washington St, Claremont, NH 03743-5504 | 2007-04-17 |
| 1770630733 | Dennis M Wagner | Optometrist | 2901 Curry Ford Rd, Suite 214, Orlando, FL 32806-3300 | 2007-01-04 |
| 1912087297 | Dennis H Wagner | Pharmacist | 2703 N Rockwell Ave, Bethany, OK 73008-5246 | 2006-10-17 |
| 1427147792 | Dennis S Wagner | Dentist | 2103 10th St, Tillamook, OR 97141-3912 | 2006-10-12 |
| 1700801800 | Dennis A Wagner | Anesthesiology | 4005 Orchard Dr, Midland, MI 48670-0001 | 2006-07-12 |
| 1891750501 | Dennis L Wagner | Anesthesiology | 550 University Blvd, Indianapolis, IN 46202-5149 | 2006-04-18 |
| Street Address |
1169 EASTERN PKWY STE 2238 |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40217-1444 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164429320 | Jeanne Marie Bennett | Clinical Neuropsychologist | 1169 Eastern Pkwy Ste 2238, Louisville, KY 40217-1444 | 2005-07-02 |
| 1760795066 | Dawn Skees | Dentist | 1169 Eastern Pkwy Ste 2238, Louisville, KY 40217-1444 | 2010-07-15 |
| 1790955334 | J Bennett Group Psc | Clinical Neuropsychologist | 1169 Eastern Pkwy Ste 2238, Louisville, KY 40217-1444 | 2008-03-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720564016 | Kaela Marie Turley | Nurse Practitioner | 2355 Poplar Level Rd Ste 405, Louisville, KY 40217 | 2018-07-19 |
| 1740710623 | Landmark of Louisville Rehabilitation and Nursing Center | Skilled Nursing Facility | 1155 Eastern Parkway, Louisville, KY 40217 | 2017-06-14 |
| 1386185437 | Meredith Brooke Ervin | Counselor | 1169 Eastern Pkwy Ste 3310, Louisville, KY 40217 | 2017-03-08 |
| 1437507621 | Kendra Pickerill | Speech-Language Pathologist | 906 Delor Avenue, Louisville, KY 40217 | 2016-05-27 |
| 1275947186 | Gary Muncy | Massage Therapist | 607 East Brandeis Ave, Louisville, KY 40217 | 2014-06-18 |
| 1912318791 | Stacey Charlotte Elmes | Case Manager/Care Coordinator | 2338 Alexanderave, Louisville, KY 40217 | 2014-05-14 |
| 1275819831 | April Mecasha Cox | Pharmacist | 808 Eastern Parkway, Louisville, KY 40217 | 2011-10-27 |
| 1831346204 | Nikki Renee Wilson | Registered Nurse | 1169 Eastern Pkwy Ste 1226, Louisville, KY 40217 | 2008-08-27 |
| 1497925440 | Sarah Beth Murrow | Chiropractor | 1100 Milton St, Louisville, KY 40217 | 2008-03-06 |
| 1457560302 | Ferenc Pantaleone Nagy | Surgery | 3 Audubon Plaza Dr Ste 220, Louisville, KY 40217 | 2007-05-21 |
| Find all providers in zip 40217 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396377164 | Mariya Leyderman | Psychologist | 974 Breckenridge Ln # 171, Louisville, KY 40207-4619 | 2020-02-10 |
| 1841821196 | Sally Losson Brenzel | Psychologist | 10503 Timberwood Cir Ste 205, Louisville, KY 40223-5395 | 2020-01-27 |
| 1013495902 | Melissa Ann Gibson | Psychologist | 6500 Glenridge Park Pl Ste 3, Louisville, KY 40222-3450 | 2018-08-01 |
| 1437645934 | Flourish Louisville | Psychologist | 6000 Brownsboro Park Blvd Ste A, Louisville, KY 40207-7201 | 2018-07-09 |
| 1982197737 | Louisville Center for Eating Disorders LLC | Psychologist | 11824 Ransum Dr # 200, Louisville, KY 40243-2802 | 2018-06-07 |
| 1801305461 | Elizabeth Swabek | Psychologist | 3703 Taylorsville Rd Ste 221, Louisville, KY 40220-1331 | 2017-09-27 |
| 1487173712 | The Wright Psychology and Learning Center, Pllc | Psychologist | 4010 Dupont Cir Ste 401, Louisville, KY 40207-4887 | 2017-09-19 |
| 1013371699 | Deshields Behavioral Wellness, Inc. | Psychologist | 2515 Gardiner Ln, Louisville, KY 40205-3003 | 2016-04-08 |
| 1851767974 | Clement Street Russell | Psychologist | 912 Lily Creek Rd, #201, Louisville, KY 40243-2815 | 2015-08-12 |
| 1306235452 | Katrina Mcbride | Psychologist | 6009 Brownsboro Park Blvd Ste C, Louisville, KY 40207-1291 | 2015-01-13 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40217 |
Please comment or provide details below to improve the information on DR. DENNIS E WAGNER.
| 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.