MS. BLAIR SUZANNE WAGEMANN (NPI# 1306051305) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306051305 |
| Entity Type | Individual |
| Full Name | MS. BLAIR SUZANNE WAGEMANN |
| Credential | P.D. |
| Practice Address |
153 E Monte Painter Dr Fayetteville AR 72703-4002 |
| Mailing Address |
13240 N Old Wire Rd Rogers AR 72756-9885 |
| Practice Telephone | 4794442259 |
| Mailing Telephone | 4794510413 |
| Mailing Fax Number | 4794510413 |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 007777 | AR | Pharmacy Service Providers |
| Street Address |
153 E MONTE PAINTER DR |
| City | FAYETTEVILLE |
| State | AR |
| Zip Code | 72703-4002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730183492 | Kevin Martin Hurlbut | Physical Medicine & Rehabilitation | 153 E Monte Painter Dr, Fayetteville, AR 72703-4002 | 2005-06-10 |
| 1194360842 | Macie Vaughan Snider | Nurse Practitioner | 153 E Monte Painter Dr, Fayetteville, AR 72703-4002 | 2019-11-15 |
| 1417343328 | Avin D Rekhi Md Pa | Specialist | 153 E Monte Painter Dr, Fayetteville, AR 72703-4002 | 2015-04-08 |
| 1760894380 | Jason Allen Hunt | Physical Medicine & Rehabilitation | 153 E Monte Painter Dr, Fayetteville, AR 72703 | 2014-06-02 |
| 1255630133 | Terry Weaver Pllc | Family Medicine | 153 E Monte Painter Dr, Healthsouth Rehabilitation Hospital, Fayetteville, AR 72703 | 2011-03-18 |
| 1467670802 | Marty Hurlbut, M.d., Pa | Physical Medicine & Rehabilitation | 153 E Monte Painter Dr, Fayetteville, AR 72703-4002 | 2007-04-23 |
| 1316038029 | Mark E. Miller, M.d., Pa | Family Medicine | 153 E Monte Painter Dr, Fayetteville, AR 72703-4002 | 2006-09-27 |
| 1265406102 | Northwest Arkansas Rehabilitation Associates | Rehabilitation Hospital | 153 E Monte Painter Dr, Fayetteville, AR 72703-4002 | 2006-02-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477154391 | Margaret Sorrells | Pharmacist | 3909 N Mall Ave Attn:pharmacy, Fayetteville, AR 72703 | 2020-11-06 |
| 1497369631 | Justin A Rand | Massage Therapist | 88 W Colt Square Dr, Fayetteville, Ar 72703, Fayetteville, AR 72703 | 2020-09-04 |
| 1235777558 | Washington Regional Medical System | Specialist | 3264 N North Hills Blvd, Fayetteville, AR 72703 | 2019-12-17 |
| 1760024582 | Haley Brooke Thompson | Occupational Therapist | 2474 E Joyce Blvd Ste 2, Null, Fayetteville, AR 72703 | 2019-10-14 |
| 1306492129 | Bhg L, LLC | Clinic/Center | 8 Colt Square Drive, Fayetteville, AR 72703 | 2019-08-16 |
| 1306406269 | Idell Marie Mitchell | Optometrist | Eye Clinic, 1100 N College Ave, Fayetteville, AR 72703 | 2019-06-13 |
| 1821574815 | Toni Myer | Nurse Practitioner | 3 E Appleby Rd Ste 101, Fayetteville, AR 72703 | 2018-07-13 |
| 1306340393 | Josh Kelfer | Student in an Organized Health Care Education/Training Program | 1125 North College Avenue, Fayetteville, AR 72703 | 2018-03-22 |
| 1649726449 | Vantage Point of Nwa | Community/Behavioral Health | 4171 N. Crossover Rd, Fayetteville, AR 72703 | 2016-08-31 |
| 1386097137 | Jason Nordstrom | Speech-Language Pathologist | 2664 N Valencia Ave, Fayetteville, AR 72703 | 2016-07-18 |
| Find all providers in zip 72703 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477154391 | Margaret Sorrells | Pharmacist | 3909 N Mall Ave Attn:pharmacy, Fayetteville, AR 72703 | 2020-11-06 |
| 1710587605 | Jordan Tyler Reed | Pharmacist | 2875 W Mlk Blvd, Fayetteville, AR 72704-7625 | 2020-10-29 |
| 1891395901 | Todd Johnson | Pharmacist | 660 W Mlk Blvd, Fayetteville, AR 72701-6443 | 2020-10-28 |
| 1669087953 | Elton Wayne Long | Pharmacist | 5106 Nc Highway 87 S Ste 100, Fayetteville, NC 28306-3424 | 2020-09-13 |
| 1013539501 | Lauren Lockhart | Pharmacist | 5106 Nc-87 #100, Fayetteville, NC 28306 | 2020-05-07 |
| 1548892268 | Kimberly Gardner | Pharmacist | 4205 Ferncreek Dr, Fayetteville, NC 28314-2537 | 2020-02-11 |
| 1326685249 | Belinda Diane Abrams | Pharmacist | 175 Jacob Ct, Fayetteville, GA 30214-7541 | 2019-12-10 |
| 1699332098 | Kyndra Williams | Pharmacist | 101 Robeson St Ste 101, Fayetteville, NC 28301-5552 | 2019-05-22 |
| 1235610098 | Debra W Nichol | Pharmacist | 217 W Maple Ave # 2, Fayetteville, WV 25840-1413 | 2018-08-28 |
| 1093293607 | Allyson Holland | Pharmacist | 880 Highway 85 South, Fayetteville, GA 30214 | 2018-08-06 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 72703 |
Please comment or provide details below to improve the information on MS. BLAIR SUZANNE WAGEMANN.
| 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.