KAYLEIGH WAGNER (NPI# 1316594674) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316594674 |
| Entity Type | Individual |
| Full Name | KAYLEIGH WAGNER |
| Credential | LAT, ATC |
| Practice Address |
501 W 12th St Erie PA 16501-1536 |
| Mailing Address |
1443 Greenfield Dr Erie PA 16509-2912 |
| Practice Telephone | 8144553719 |
| Mailing Telephone | 8146029206 |
| Enumeration Date | 2019-08-21 |
| Last Update Date | 2019-08-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2083S0010X |
Preventive Medicine Specialization: Sports Medicine |
RT006112 | PA | Allopathic & Osteopathic Physicians |
| Street Address |
501 W 12TH ST |
| City | ERIE |
| State | PA |
| Zip Code | 16501-1536 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174023261 | Megan Elizabeth Goodrich | Specialist/Technologist | 501 W 12th St, Erie, PA 16501-1536 | 2018-02-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306496872 | Maureen Grady | Physician Assistant | 240 West 11th Street, Suite 2, Erie, PA 16501 | 2019-09-17 |
| 1093291023 | Passavant Development Corporation | Pharmacy | 1611 Peach St Ste 400, Erie, PA 16501 | 2018-07-12 |
| 1073043675 | Stephanie Owens | Specialist/Technologist | 211 West 8th Street, Erie, PA 16501 | 2017-06-15 |
| 1114335130 | Julia Campbell | Occupational Therapist | 207 W. 11th. St., Suite 402, Erie, PA 16501 | 2014-07-23 |
| 1669766481 | Seth David Fox | Ophthalmology | 128 West 12 St, Ste 200, Erie, PA 16501 | 2011-06-09 |
| 1336438910 | Maryna Petrasheuskaya | Dentist | 1611 State Street, 465, Erie, PA 16501 | 2011-04-04 |
| 1891092565 | Amber Leann Allshouse | Counselor | 1602 State St Ste 390, Erie, PA 16501 | 2011-02-16 |
| 1225331986 | Jennifer Marie Kuzmin | Counselor | 1001 State St Ste 1409, Erie, PA 16501 | 2010-12-17 |
| 1093026510 | Community Health Net | Pharmacy | Daniel S. Snow M.d. Health Center, 1202 State Street, Erie, PA 16501 | 2010-06-30 |
| 1467634113 | Chester Francis Battersby Sr. | Chiropractor | 265 West 10th St, Erie, PA 16501 | 2007-12-04 |
| Find all providers in zip 16501 | ||||
| Taxonomy Code | 2083S0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Preventive Medicine |
| Specialization | Sports Medicine |
| A preventive medicine physician who specializes in the diagnosis and treatment of sports related conditions and injuries. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Preventive Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629628086 | Janele Allison Wolbert | Preventive Medicine | 434 Montpelier Ave, Erie, PA 16505-1523 | 2019-09-18 |
| 1447419536 | Medical Associates of Erie | Preventive Medicine | 5515 Peach St, Erie, PA 16509-2603 | 2008-06-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871008490 | Diane Boyce | Preventive Medicine | Bucknell University, Moore Ave., Klarc Gym, Lewisburg, PA 17837-1783 | 2017-12-05 |
| 1700302858 | Daniel S Hensley | Preventive Medicine | 201 Grampian Blvd, Williamsport, PA 17701-1813 | 2017-08-21 |
| 1043687551 | Kenneth Marsaglia II | Preventive Medicine | 8414 Bridle Road, Philadelphia, PA 19111 | 2015-09-01 |
| 1952318859 | Tracy William Ross | Preventive Medicine | South 4th Street, Denver, PA 17517-0800 | 2006-08-02 |
| 1043275928 | Joseph Michael Borysowski | Preventive Medicine | 717 E High St, Pottstown, PA 19464-5770 | 2006-04-20 |
| 1760021158 | Kyle Fisher | Preventive Medicine | 101 N College Ave, Annville, PA 17003-1404 | 2020-01-02 |
| 1568027050 | Aubrie Ann Stouffer | Preventive Medicine | 801 Ostrum St, Fountain Hill, PA 18015-1000 | 2019-05-09 |
| 1780158121 | Larissa J Roberts | Preventive Medicine | 410 Pellis Rd, Greensburg, PA 15601-4700 | 2019-01-18 |
| 1528015591 | John Charles Green | Preventive Medicine | 1601 S Queen St, York, PA 17403-4630 | 2006-05-27 |
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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.