RICHARD K WAGNER (NPI# 1184868598) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1184868598 |
Entity Type | Individual |
Full Name | RICHARD K WAGNER |
Credential | MD |
Practice Address |
903 Mineral Point Ave Janesville WI 53548-2970 |
Practice Telephone | 6087565555 |
Practice Fax Number | 6087560174 |
Mailing Telephone | 6087565555 |
Mailing Fax Number | 6087560174 |
Enumeration Date | 2009-04-29 |
Last Update Date | 2015-07-14 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2084A0401X |
Psychiatry & Neurology Specialization: Addiction Medicine |
64250-20 | WI | Allopathic & Osteopathic Physicians |
N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1528304334 | Richard Wagner | Counselor | 5132 Mimosa Drive, Bellaire, TX 77401 | 2012-12-26 |
1326359423 | Richard Ross Wagner | Pharmacist | 3282 Bethel Rd Se, Port Orchard, WA 98366-5603 | 2010-06-23 |
1871814624 | Richard Adam Wagner | Family Medicine | 295 County Hwy. 156, Johnstown, NY 12095-4123 | 2010-06-16 |
1134443559 | Richard Alan Wagner | Pharmacist | 23631 Dane Ct, Laguna Niguel, CA 92677-4618 | 2010-03-15 |
1043470214 | Richard W Wagner Jr. | Dentist | 123 W Franklin St, Suite 201, Chapel Hill, NC 27516-2524 | 2008-06-11 |
1962621631 | Richard Wagner | Specialist | 1789 Rebecca Lane, Coupeville, WA 98239-0339 | 2007-04-24 |
1770700957 | Richard M Wagner | Dentist | 1925 South Green Bay Rd, Racine, WI 53406-4654 | 2007-04-19 |
1619019676 | Richard Chisholm Wagner | Dentist | 1150 S King St Ste 303, Honolulu, HI 96814-1951 | 2007-02-13 |
1134236334 | Richard Laverne Wagner | Psychiatry & Neurology | 12 Benevolent St, Providence, RI 02906-1103 | 2006-08-24 |
1669488946 | Richard Wagner | Psychiatry & Neurology | 101 Lions Dr, Suite 119, Barrington, IL 60010-3181 | 2006-07-31 |
Street Address |
903 MINERAL POINT AVE |
City | JANESVILLE |
State | WI |
Zip Code | 53548-2970 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1811927205 | Mary T. Bonaccorsi | Nurse Practitioner | 903 Mineral Point Ave, Janesville, WI 53548-2970 | 2006-07-03 |
1417581745 | Tanya N. Olin | Registered Nurse | 903 Mineral Point Ave, Janesville, WI 53548-2970 | 2020-02-25 |
1396391728 | Briann N. Modos | Registered Nurse | 903 Mineral Point Ave, Janesville, WI 53548-2970 | 2019-08-12 |
1114579364 | Jessica A. Wallace | Registered Nurse | 903 Mineral Point Ave, Janesville, WI 53548-2970 | 2019-07-09 |
1811403769 | Rachel V. Sanderson | Counselor | 903 Mineral Point Ave, Janesville, WI 53548-2970 | 2017-12-14 |
1972038958 | Shelby L. Kandziora | Counselor | 903 Mineral Point Ave, Janesville, WI 53548-2970 | 2017-04-27 |
1093255929 | Ashley A. Crull | Psychologist | 903 Mineral Point Ave, Janesville, WI 53548 | 2017-02-25 |
1639617855 | Stacy M. Condon | Social Worker | 903 Mineral Point Ave, Janesville, WI 53548-2970 | 2017-02-08 |
1841744216 | Kelly A. Janes | Counselor | 903 Mineral Point Ave, Janesville, WI 53548-2970 | 2016-08-15 |
1366892044 | Sara J Maly | Counselor | 903 Mineral Point Ave, Janesville, WI 53548-2970 | 2016-06-14 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1578846010 | Patricia Ann Sheets | Licensed Vocational Nurse | 316 N. Terrace St., Janbesville, WI 53548 | 2011-09-21 |
1760658983 | Kristy Kay Prentice Kerl | Dental Hygienist | 121 Jonathon Dr, Janesville, WI 53548 | 2008-05-07 |
1316005978 | City of Janesville | Emergency Medical Technician, Paramedic | 18 N Jackson St, Janesville, WI 53548 | 2006-12-05 |
1558464115 | Sarah Louise Hessenauer | Social Worker | 17 S. River St, Suite 254, Janesville, WI 53548 | 2006-09-07 |
1073548327 | Mary Katherine Cefalu | Registered Nurse | 17 S. River, Suite 254, Janesville, WI 53548 | 2006-07-12 |
1699707950 | Gary Lavern Jones | Counselor | 175 River, Suite 254, Janesville, WI 53548 | 2006-07-07 |
1295767424 | Michael Stuart Kaye | Clinical Neuropsychologist | 17 S River St Ste 254, Janesville, WI 53548 | 2006-07-07 |
1205864055 | Amy Laurie Roy | Counselor | 17 S River Suite 254, Janesville, WI 53548 | 2006-06-29 |
1518903566 | Leota I Larson | Psychologist | 17 S River, Suite 254, Janesville, WI 53548 | 2006-06-20 |
1760950414 | North Star Chiropractic LLC | Chiropractor | 21 S Jackson St, Ste 160, Janesville, WI 53548 | 2018-11-10 |
Find all providers in zip 53548 |
Taxonomy Code | 2084A0401X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Psychiatry & Neurology |
Specialization | Addiction Medicine |
A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |
Notes: Source: American Osteopathic Board of Neurology and Psychiatry, 2007 [1/1/2008: definition added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1538352323 | Stephen B Hull | Psychiatry & Neurology | 8315 Steeple Hill Dr, Larsen, WI 54947-9538 | 2007-08-24 |
1124148747 | Ivars Gailans | Psychiatry & Neurology | 180 N Milwaukee St, Milwaukee, WI 53202-6013 | 2007-03-29 |
1780730515 | Sheila W. Sorkin, M.d. LLC | Psychiatry & Neurology | 11430 W Bluemound Rd, Suite 109, Wauwatosa, WI 53226-4050 | 2007-01-26 |
1568577534 | Sheila W Sorkin | Psychiatry & Neurology | 11430 W. Bluemound Road Suite 109, Wauwatosa, WI 53226 | 2006-08-20 |
1548206360 | William Carlin Bucknam | Psychiatry & Neurology | 1018 Gammon Ln, Madison, WI 53719-2256 | 2006-06-21 |
1205873882 | Paul W Harris | Psychiatry & Neurology | 3267 S 16tj Street, Room 200, Milwaukee, WI 53215-4500 | 2006-06-01 |
1417461401 | Jennifer Lynn Brubaker | Psychiatry & Neurology | 2842 S Business Dr, Sheboygan, WI 53081-6518 | 2017-11-29 |
1417322868 | Prevail Psychiatry LLC | Psychiatry & Neurology | 2222 N Mayfair Rd, Wauwatosa, WI 53226-2208 | 2015-12-10 |
1740469873 | Raymond W. Moy Md Sc | Psychiatry & Neurology | 6917 W Oklahoma Ave, Milwaukee, WI 53219-2973 | 2007-10-25 |
1487709200 | Matthew A Felgus | Psychiatry & Neurology | 6333 Odana Rd, Suite 3, Madison, WI 53719-1170 | 2007-01-24 |
Find all providers with the same taxonomy |
City | JANESVILLE |
Zip Code | 53548 |
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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.