AMY NICOLE WAGNER (NPI# 1326085507) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326085507 |
| Entity Type | Individual |
| Full Name | AMY NICOLE WAGNER |
| Credential | PA |
| Practice Address |
675 W Washington Ave Madison WI 53703-2637 |
| Practice Telephone | 6082579700 |
| Practice Fax Number | 6082502015 |
| Mailing Telephone | 6082579700 |
| Mailing Fax Number | 6082502015 |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2017-04-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
1704-023 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639642937 | Amy Danielle Wagner | Marriage & Family Therapist | 523 Dixie St Ste 5, Carrollton, GA 30117-3870 | 2019-01-09 |
| 1649695628 | Amy L. Wagner | Behavioral Analyst | 1128 Beville Road, Suite A, Daytona Beach, FL 32114 | 2014-02-27 |
| 1538463997 | Amy Lyn Wagner | Occupational Therapist | 2820 E 53rd Ave, Apt # 48, Spokane, WA 99223-7962 | 2010-12-28 |
| 1710033097 | Amy E Wagner | Physical Therapist | 1428 S Marengo Ave, Alhambra, CA 91803-3001 | 2007-01-26 |
| 1568516698 | Amy Claire Wagner | Psychologist | 104 Central Park Ave, Wilmette, IL 60091-3202 | 2007-01-23 |
| 1174186217 | Amy Marie Wagner | Student in an Organized Health Care Education/Training Program | 6901 Bertner Ave, Houston, TX 77030-3901 | 2019-04-15 |
| 1639654437 | Amy Elizabeth Wagner | Speech-Language Pathologist | 631 Main Street, Richfield, PA 17086 | 2018-09-27 |
| 1568989697 | Amy S Wagner | Counselor | 3544 Edgewater Dr, Orlando, FL 32804-2922 | 2017-08-29 |
| 1942742804 | Amy Nicole Wagner | Nurse Practitioner | 150 N Robertson Blvd, Beverly Hills, CA 90211-2142 | 2016-11-09 |
| 1801340393 | Amy Wagner | Counselor | 2272 95th St, Unit 305, Naperville, IL 60564-8942 | 2016-08-12 |
| Street Address |
675 W WASHINGTON AVE |
| City | MADISON |
| State | WI |
| Zip Code | 53703-2637 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861481699 | Patricia Ruth Witte | Family Medicine | 675 W Washington Ave, Madison, WI 53703-2637 | 2005-10-14 |
| 1386125656 | Sara Camacho | Counselor | 675 W Washington Ave, Madison, WI 53703-2637 | 2018-08-24 |
| 1407340177 | Rebekah Lynn Steidinger | Physical Therapist | 675 W Washington Ave, Madison, WI 53703-2637 | 2018-06-18 |
| 1972012284 | Sarah Henson | Pharmacist | 675 W Washington Ave, Madison, WI 53703-2637 | 2017-09-29 |
| 1356867006 | Kyoko Felland | Physician Assistant | 675 W Washington Ave, Madison, WI 53703-2637 | 2017-08-15 |
| 1255860318 | Kaitlin Alexandra Kamer | Physician Assistant | 675 W Washington Ave, Madison, WI 53703-2637 | 2017-06-12 |
| 1831628825 | Shane Berken | Pharmacist | 675 W Washington Ave, Madison, WI 53703-2637 | 2017-06-05 |
| 1659810109 | Jillian Utschig | Pharmacist | 675 W Washington Ave, Madison, WI 53703-2637 | 2017-02-16 |
| 1922542760 | Amanda Grace Slawter | Social Worker | 675 W Washington Ave, Madison, WI 53703-2637 | 2016-12-13 |
| 1922470673 | Sarah Spolum | Physician Assistant | 675 W Washington Ave, Madison, WI 53703-2637 | 2015-10-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689291254 | Lynne's Moc, LLC | Optometrist | 512 State Street, Madison, WI 53703 | 2020-06-30 |
| 1407327844 | Deborah Ann Pape | Psychologist | 350 S. Hamilton St., Unit 504, Madison, WI 53703 | 2018-12-11 |
| 1336660216 | Kevin Shuai Lian | Radiology | 420 W Dayton St Unit 1142, Madison, WI 53703 | 2017-06-30 |
| 1295279461 | Colin T Graney | Podiatrist | 664 W. Washington Ave, Madison, WI 53703 | 2016-12-07 |
| 1093193690 | Ashley Przybilla | Pediatrics | Group Health Cooperative of South Central Wisconsin, 675 West Washington Avenue, Madison, WI 53703 | 2015-05-14 |
| 1043606841 | Kevin P Emmerich | Emergency Medicine | 390 West Johnson St, Madison, WI 53703 | 2015-04-09 |
| 1376983155 | Ann Renee Wingate | Counselor | 16 N. Hancock Street, Hancock Center, Madison, WI 53703 | 2013-06-26 |
| 1013269398 | See Inc | Optometrist | 437 State St, Madison, WI 53703 | 2012-10-10 |
| 1518243237 | Nathan Dufault | Specialist/Technologist | 305 S. Livingston St., Madison, WI 53703 | 2011-10-26 |
| 1518264142 | Candice Y Lewis | Health Maintenance Organization | 675 W.washington Ave. Group Health Cooperative of South, Madison, WI 53703 | 2011-02-17 |
| Find all providers in zip 53703 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962804211 | Miranda Street Sudduth | Physician Assistant | 1607 Doctors Drive, Madison, MS 39110 | 2014-09-18 |
| 1184944068 | Thomas Harvey Greene IIi | Physician Assistant | 248 Ne Hancock Ave, Madison, FL 32340-2560 | 2010-06-02 |
| 1699001735 | Chad Jamison Gilliam | Physician Assistant | 1230 Slaughter Rd Ste C, Madison, AL 35758-5901 | 2009-10-24 |
| 1679763700 | Tamara A Melone | Physician Assistant | 2802 International Lane, Madison, WI 53708-0017 | 2007-07-25 |
| 1932237138 | Craig Michael Roberts | Physician Assistant | 2631 Chamberlain Ave, Madison, WI 53705-3717 | 2007-03-01 |
| 1639234610 | Sally-ann P Johannsen | Physician Assistant | 717 Hidden Cave Rd, Madison, WI 53717-2755 | 2006-12-27 |
| 1023105467 | Nicole Anna Hanson | Physician Assistant | 1617 Sherman Avenue, Madison, WI 53708-0017 | 2006-10-06 |
| 1730137548 | Renee A Knutson | Physician Assistant | 38 Hidden Hollow Trl, Madison, WI 53717-2501 | 2006-05-04 |
| 1669439329 | Deanna J Nakada | Physician Assistant | 750 University Row, Madison, WI 53705-1311 | 2006-04-27 |
| 1326002213 | Angela K Vitcenda | Physician Assistant | 701 Dane Street, Madison, WI 53713 | 2006-04-17 |
| Find all providers in MADISON | ||||
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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.