SCOTT FORBES WAGNER (NPI# 1356801237) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356801237 |
| Entity Type | Individual |
| Full Name | SCOTT FORBES WAGNER |
| Credential | MD |
| Practice Address |
55 Lake Ave N Worcester MA 01655-0002 |
| Practice Telephone | 5083341000 |
| Mailing Telephone | 5083341000 |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2019-03-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871113316 | Scott D Wagner I | Counselor | 319 E Tabor Ave Apt 15319, Fairfield, CA 94533-3955 | 2020-04-24 |
| 1932558822 | Scott Wagner | Pharmacist | 1018 Rosemont, Carmel, IN 46032-7709 | 2016-06-10 |
| 1124492350 | Scott Wagner | Speech-Language Pathologist | 5045 Kennelwood Dr, Saint Louis, MO 63129-2424 | 2015-11-27 |
| 1841514593 | Scott Davis Wagner | Pharmacist | 25059 State Route 11, Hallstead Plaza, Hallstead, PA 18822-8831 | 2010-03-24 |
| 1902909005 | Scott William Wagner | Dentist | 9035 East 62nd Street South, Tulsa, OK 74133 | 2006-09-06 |
| 1053340588 | Scott Brian Wagner | Chiropractor | 2109 India Rd, Charlottesville, VA 22901-2886 | 2006-06-30 |
| 1811279995 | Scott Wagner | Community Health Worker | 312 Crescent St, Greenville, CA 95947 | 2011-09-14 |
| 1861703613 | Scott Wagner | Orthopaedic Surgery | 8901 Wisconsin Ave, Bethesda, MD 20889-0001 | 2010-06-27 |
| 1538486162 | Scott Allen Wagner | Occupational Therapist | 210 S 12th St, Bismarck, ND 58504-5622 | 2010-04-21 |
| 1841499258 | Scott John Wagner | Registered Nurse | 3537 S I-35 E, Suite 305, Denton, TX 76210-6800 | 2007-07-16 |
| Street Address |
55 LAKE AVE N |
| City | WORCESTER |
| State | MA |
| Zip Code | 01655-0002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477556587 | James E Liebmann | Internal Medicine | 55 Lake Ave N, Hematology/oncology, Worcester, MA 01655-0002 | 2005-05-23 |
| 1518568732 | Justin Bullard | Psychologist | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-11-04 |
| 1346849825 | Meghan Moore | Nurse Practitioner | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-10-26 |
| 1174122899 | Jessica Goncalves Ferreira | Nurse Practitioner | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-10-23 |
| 1235746686 | Desiree Mytych | Student in an Organized Health Care Education/Training Program | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-09-29 |
| 1659986248 | Rebecca Lynn Harris | Student in an Organized Health Care Education/Training Program | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-09-10 |
| 1639781487 | Gabriella Kathleen Holland | Student in an Organized Health Care Education/Training Program | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-08-21 |
| 1730791898 | Kerry Anne Benedict | Speech-Language Pathologist | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-08-20 |
| 1902418999 | Natasha R. Turner | Genetic Counselor, MS | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-08-20 |
| 1144830712 | Abbey Corsini | Nurse Practitioner | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-08-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205489713 | Darryl Sweeper Jr. | Student in an Organized Health Care Education/Training Program | 55 Lake Avenue North, Psychiatry, Umass Memorial Medical Center, Worcester, MA 01655 | 2019-07-23 |
| 1225690530 | Ryan Zenevitch | Student in an Organized Health Care Education/Training Program | 55 Lake Avenue North, Family Medicine, Umass Memorial Medical Center, Worcester, MA 01655 | 2019-07-08 |
| 1932688454 | Victoria Sayeg | Student in an Organized Health Care Education/Training Program | 55 Lake Avenue North, Pediatrics, Worcester, MA 01655 | 2018-08-07 |
| 1114425675 | Judith Dio Wentzell | Social Worker | Umassmemorial Medical Center, 55 Lake Ave North, Dept of Care Coordination, Worcester, MA 01655 | 2018-01-30 |
| 1861927386 | Muhammad Waqas Khan | Student in an Organized Health Care Education/Training Program | University of Massachusetts 55 North Lake Ave, Neurology, Worcester, MA 01655 | 2017-04-21 |
| 1861806192 | Qaiser Shamshir Khan | Psychiatry & Neurology | 55 Lake Ave N # S7-831, Worcester, MA 01655 | 2014-06-14 |
| 1073858981 | Heidi Glover | Nurse Practitioner | 55 Lake Ave North Dept. of Pedi-adolescent, Ummc University Campus, Worcester, MA 01655 | 2012-12-04 |
| 1972867992 | Anna Bjornsdottir | Psychiatry & Neurology | 55 Lake Av N, Worcester, MA 01655 | 2012-06-25 |
| 1245567676 | Steven Edward Mckinley | Nurse Practitioner | 55 Lake Ave. North, Umass Memorial Medical Center University Campus, Worcester, MA 01655 | 2009-11-05 |
| 1851582951 | Robin I Davidson | Neurological Surgery | 55 Lake Ave, North, Ummhc-univ Campus, Worcester, MA 01655 | 2007-08-05 |
| Find all providers in zip 01655 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326661927 | Ekaterina V Pimental | Student in an Organized Health Care Education/Training Program | 72 Salisbury St Apt 5, Worcester, MA 01609-3134 | 2020-05-19 |
| 1841810900 | Charles Purcell | Student in an Organized Health Care Education/Training Program | 80 Carter Rd, Worcester, MA 01609-1038 | 2020-04-19 |
| 1942839832 | Nicole Elizabeth Lewandrowski | Student in an Organized Health Care Education/Training Program | Pathology-1 Innovation Drive, Biotech 3, Worcester, MA 01604 | 2020-04-03 |
| 1982232336 | Min Zhang | Student in an Organized Health Care Education/Training Program | 1 Innovation Dr. Biotech 3, Worcester, MA 01605-4306 | 2020-03-31 |
| 1336777952 | Zhenwei Zhang | Student in an Organized Health Care Education/Training Program | 1 Innovation Dr Ste 2, Worcester, MA 01605-4306 | 2020-03-30 |
| 1932736634 | Gregory Stephen Kazarian | Student in an Organized Health Care Education/Training Program | 2 Marissa Cir, Worcester, MA 01604-2674 | 2020-03-24 |
| 1376178590 | Seungju Oh | Student in an Organized Health Care Education/Training Program | 55 Lake Ave N # S4-740, Worcester, MA 01655-0002 | 2020-03-09 |
| 1962032946 | Samuel James Casey | Student in an Organized Health Care Education/Training Program | 4 Normal St Apt 2, Worcester, MA 01605-3496 | 2020-01-18 |
| 1265072169 | Klajdi Kosovrasti | Student in an Organized Health Care Education/Training Program | 46 Fox Meadow Dr, Worcester, MA 01602-2242 | 2020-01-09 |
| 1669012449 | Jacob Moninghoff | Student in an Organized Health Care Education/Training Program | 16 Norton St Apt 1, Worcester, MA 01605-3780 | 2020-01-09 |
| Find all providers in WORCESTER | ||||
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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.