WAGONER MEDICAL CENTER, LLC (NPI# 1457421497) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457421497 |
| Entity Type | Organization |
| Organization Name | WAGONER MEDICAL CENTER, LLC |
| Practice Address |
605 East 7th Street Burlington IN 46915-0038 |
| Mailing Address |
Po Box 38 Burlington IN 46915-0038 |
| Practice Telephone | 7655663351 |
| Practice Fax Number | 7655662250 |
| Mailing Telephone | 7655663351 |
| Mailing Fax Number | 7655662250 |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2009-05-15 |
| Authorized Official Name | MICHELLE WAGONER (ADMINISTRATOR) |
| Authorized Official Telephone | 7655663351 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
Allopathic & Osteopathic Physicians | ||
| N | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200062260 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245458355 | Wagoner Medical Center, LLC | Internal Medicine | 2016 W Sycamore, Kokomo, IN 46901 | 2007-04-23 |
| 1194940080 | Wagoner Medical Center, LLC | Internal Medicine | 821 N Dixon Rd, Kokomo, IN 46901-1754 | 2007-04-16 |
| Street Address |
605 EAST 7TH STREET |
| City | BURLINGTON |
| State | IN |
| Zip Code | 46915-0038 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295104669 | Purdue University | Clinic/Center | 425 E 5th Street, Suite B, Burlington, IN 46915 | 2015-09-16 |
| 1205955150 | Gary Hartman | Physician Assistant | 605 East 7th St., Burlington, IN 46915-0038 | 2007-03-29 |
| 1134525645 | Amy R Aeschliman | Nurse Practitioner | 425 E. 5th Street, Suite B, Burlington, IN 46915-1758 | 2014-11-10 |
| 1568432367 | Marius Julian Nefliu | Internal Medicine | 400 W 7th Street, Frederick Memorial Hospital, Frederick, MD 46915-9441 | 2006-01-24 |
| 1285614511 | Don J Wagoner | Family Medicine | 605 E 7th St, Burlington, IN 46915-9441 | 2006-01-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346841376 | Ralf F. Schuler, Dr. Med. Dent., Msd,pllc | Clinic/Center | 205 W Fairhaven Ave Ste C, Burlington, WA 98233-1062 | 2020-11-05 |
| 1013517614 | William Reed | Pharmacist | 31413 County Road 720, Burlington, OK 73722-4475 | 2020-11-01 |
| 1730789686 | Paige Perkins | Licensed Practical Nurse | 5 Hardy Ave, Burlington, VT 05408-1203 | 2020-10-29 |
| 1811596216 | Convenientmd LLC | Clinic/Center | 181 Cambridge St, Burlington, MA 01803-2922 | 2020-10-19 |
| 1982202966 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 1433 Boone Station Dr, Burlington, NC 27215-8229 | 2020-10-13 |
| 1578170866 | Private Healthcare Facilities | Clinic/Center | 5617 Spring Valley Rd, Burlington, WI 53105-9003 | 2020-09-30 |
| 1801402755 | Marnie Meisner | Registered Nurse | 4004 Lake St, Burlington, WI 53105-9449 | 2020-09-16 |
| 1619582509 | Cheyanne Mckay Alexander | Technician | 369 Hillbilly Heaven Rd, Burlington, WV 26710-7596 | 2020-09-09 |
| 1669086948 | October Road, Inc. | Community/Behavioral Health | 1304 Plaza Dr Ste 2312, Burlington, NC 27215-7165 | 2020-09-03 |
| 1689288300 | Barbara A Crotty | Massage Therapist | 2879c Rob Shepard Dr, Burlington, NC 27215-9299 | 2020-09-01 |
| Find all providers in BURLINGTON | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447594056 | Armc Physicians Care, Inc. | Family Medicine | 3128 Commerce Pl, Burlington, NC 27215-5157 | 2012-11-20 |
| 1215214374 | Westside Ob/gyn Center, Pa | Family Medicine | 1694 Westbrook Ave, Burlington, NC 27215-9700 | 2011-11-03 |
| 1528343258 | Andria Anita Bloom | Family Medicine | 1162 S. Burlington Boulevard, Burlington, WA 98233 | 2011-10-13 |
| 1851676704 | Urgent Cares of America North Carolina Inc | Family Medicine | 104 Huffman Mill Rd, Burlington, NC 27215-5113 | 2011-10-11 |
| 1235459074 | At Home Physicians, Pllc | Family Medicine | 38 Cliff St, Burlington, VT 05401-4505 | 2010-06-03 |
| 1730342585 | Susan M Tiona | Family Medicine | 49777 County Road V, Burlington, CO 80807-9361 | 2008-07-02 |
| 1316114994 | Rebecca Spoerri-bowman | Family Medicine | 101 Cambridge Street, Suite 380, Burlington, MA 01803-2900 | 2008-05-13 |
| 1588701056 | Jonathan Scott Strenio | Family Medicine | 96 Morrill Dr, Burlington, VT 05408-1112 | 2007-01-31 |
| 1245376300 | Sharon Anne Smith | Family Medicine | 425 Milwaukee Ave, Suite One, Burlington, WI 53105-1230 | 2007-01-29 |
| 1629139829 | John D. Ammon | Family Medicine | 3901 Petersburg Rd, Burlington, KY 41005-8786 | 2006-12-12 |
| Find all providers in BURLINGTON | ||||
| City | BURLINGTON |
| Zip Code | 46915 |
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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.