RYAN WAGNER (NPI# 1275087207) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275087207 |
| Entity Type | Individual |
| Full Name | RYAN WAGNER |
| Practice Address |
1405 Mill St New London WI 54961-2155 |
| Mailing Address |
721 E Meadow Grove Blvd Appleton WI 54915-4509 |
| Practice Telephone | 9205312000 |
| Practice Fax Number | 9205312098 |
| Enumeration Date | 2016-08-08 |
| Last Update Date | 2018-12-13 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 68001 | WI | Allopathic & Osteopathic Physicians |
| N | 207P00000X | Emergency Medicine | 125.064852 | IL | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 721 E Meadow Grove Blvd, Appleton, WI 549154509 | 9205852839 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316493489 | Ryan Wagner | Pharmacist | 2692 Lockport Rd, Sanborn, NY 14132-9350 | 2016-08-29 |
| 1114537693 | Ryan Austin Wagner | Registered Nurse | 2100 Stantonsburg Rd, Greenville, NC 27834-2818 | 2020-08-09 |
| 1841812997 | Ryan Wagner | Case Manager/Care Coordinator | 301 W 15th St, Chester, PA 19013-5300 | 2020-05-12 |
| 1720545874 | Ryan J Wagner | Specialist/Technologist | 49 Clinton Ave, Dobbs Ferry, NY 10522-2200 | 2019-02-25 |
| 1669917365 | Ryan Wagner | Psychologist | 4217 Smith Rd, Cincinnati, OH 45212-4107 | 2017-01-04 |
| 1245692086 | Ryan David Wagner | Student in an Organized Health Care Education/Training Program | 6701 Fannin St, Suite 610, Houston, TX 77030-2608 | 2016-03-22 |
| 1295062107 | Ryan James Wagner | Pharmacist | 5280 Buffalo Speedway, Houston, TX 77005-4204 | 2009-11-13 |
| 1134372980 | Ryan Scott Wagner | Family Medicine | 140 Hill St, Suite B, Bucyrus, OH 44820-1566 | 2008-10-24 |
| Street Address |
1405 MILL ST |
| City | NEW LONDON |
| State | WI |
| Zip Code | 54961-2155 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598752057 | Hiep T Poppy | Physical Therapy Assistant | 1405 Mill St, New London, WI 54961-2155 | 2005-09-30 |
| 1952918328 | Emily Becher | Physical Therapist | 1405 Mill St, New London, WI 54961-2155 | 2020-09-29 |
| 1699232132 | Alyssa Wentworth | Physician Assistant | 1405 Mill St, New London, WI 54961-2155 | 2019-02-20 |
| 1609390855 | Leah M Lemke | Physician Assistant | 1405 Mill St, New London, WI 54961-2155 | 2017-07-31 |
| 1548783228 | Kelsey Mae Abendroth | Physical Therapist | 1405 Mill St, New London, WI 54961-2155 | 2017-07-25 |
| 1609397280 | Mayka L Rambo | Registered Nurse | 1405 Mill St, New London, WI 54961-2155 | 2017-07-04 |
| 1679932750 | Kristin M Roesler | Nurse Practitioner | 1405 Mill St, New London, WI 54961-2155 | 2016-02-17 |
| 1740675040 | Bryan Kent Hendrickson | Family Medicine | 1405 Mill St, New London, WI 54961-2155 | 2015-04-02 |
| 1972928463 | New London Family Medical Center Inc | Non-Pharmacy Dispensing Site | 1405 Mill St, New London, WI 54961-2155 | 2014-02-20 |
| 1063846491 | Courtney Nicole Shirel | Physical Therapist | 1405 Mill St, New London, WI 54961-2155 | 2013-08-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407406408 | Cheryl Schneider | Technician | L 56 Northgate Estates, New London, WI 54961 | 2019-09-12 |
| 1861634719 | Rebecca L Kramer | Counselor | 315 Burton St, New London, WI 54961 | 2009-03-24 |
| 1598913501 | Marsha Ann Nytes | Licensed Practical Nurse | E8222 Weyawega Rd, New London, WI 54961 | 2008-09-03 |
| 1659585172 | Amanda L. Beck | Physical Therapy Assistant | 400 E. 4th Street, Manawa, WI 54961 | 2007-05-10 |
| 1366599433 | Griebenow Eyecare, S.c. | Optometrist | 105 Northridge Drive, New London, WI 54961 | 2007-01-04 |
| 1740822055 | Lauren Mae Flunker | Social Worker | E7475 Rawhide Rd, New London, WI 54961 | 2019-10-09 |
| 1063641249 | Forefront Dermatology, S.c. | Dermatology | 1620 N Shawano St, Suite C, New London, WI 54961 | 2009-07-08 |
| 1093982530 | Ascension Medical Group-fox Valley Wisconsin, Inc | Clinic/Center | 1420 Algoma St, New London, WI 54961 | 2008-05-14 |
| 1821263849 | Mark Alan Tegtmeier | Counselor | E7475 Rawhide Rd, New London, WI 54961 | 2008-04-30 |
| 1639282544 | Ascension Medical Group-fox Valley Wisconsin, Inc | Durable Medical Equipment & Medical Supplies | 1420 Algoma St, New London, WI 54961 | 2006-08-16 |
| Find all providers in zip 54961 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821170986 | Brian L Vanhoozen | Emergency Medicine | 1505 Mill St, New London, WI 54961-2187 | 2006-10-19 |
| 1659481067 | Daniel J Carlin | Emergency Medicine | 111 Morgan Hill Rd, New London, NH 03257-5126 | 2006-08-30 |
| 1275928830 | Chanel Elizabeth Fischetti | Emergency Medicine | 365 Montauk Ave, New London, CT 06320-4700 | 2015-03-31 |
| 1356782601 | Amy Douglass | Emergency Medicine | 365 Montauk Ave, New London, CT 06320-4769 | 2013-07-16 |
| 1467710756 | Neil Panchal | Emergency Medicine | 365 Montauk Ave, New London, CT 06320-4769 | 2012-04-25 |
| 1164742730 | Jonathan W Klingler | Emergency Medicine | 273 County Rd, New London, NH 03257-5736 | 2010-06-07 |
| 1457678138 | Theresa Adams | Emergency Medicine | 365 Montauk Ave, New London, CT 06320-4700 | 2010-04-21 |
| 1346487220 | Benjamin D Armstrong | Emergency Medicine | 365 Montauk Ave, New London, CT 06320-4700 | 2009-01-14 |
| 1255582268 | Sophia Gee O'donnell | Emergency Medicine | 365 Montauk Ave, Emergency Medicine Department, New London, CT 06320-4700 | 2008-10-08 |
| 1376793125 | Melissa Lin Monte | Emergency Medicine | 365 Montauk Ave, New London, CT 06320-4700 | 2008-09-29 |
| Find all providers in NEW LONDON | ||||
| City | NEW LONDON |
| Zip Code | 54961 |
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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.