CAROL L WAGNER (NPI# 1568570414) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568570414 |
| Entity Type | Individual |
| Full Name | CAROL L WAGNER |
| Credential | MD |
| Practice Address |
171 Ashley Ave Charleston SC 29425-0001 |
| Mailing Address |
Po Box 751461 Charlotte NC 28275-1461 |
| Practice Telephone | 8437921414 |
| Mailing Telephone | 8437926200 |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2020-10-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080N0001X |
Pediatrics Specialization: Neonatal-Perinatal Medicine |
16190 | SC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | 161906 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932233574 | Carol Wagner | Social Worker | 2346 S Lynhurst Dr, Indianapolis, IN 46241-8621 | 2007-03-15 |
| 1760537062 | Carol Theresa Wagner | Counselor | 2780 Schurz Ave, Bronx, NY 10465-3234 | 2007-01-24 |
| 1366459885 | Carol A Wagner | Speech-Language Pathologist | 5846 S Flamingo Rd, Cooper City, FL 33330-3237 | 2006-08-01 |
| Street Address |
171 ASHLEY AVE |
| City | CHARLESTON |
| State | SC |
| Zip Code | 29425-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942203922 | Nicholas J Pastis Jr. | Internal Medicine | 171 Ashley Ave, Charleston, SC 29425-8900 | 2005-05-24 |
| 1760083745 | Eleta Lazar Donelan | Physician Assistant | 171 Ashley Ave, Charleston, SC 29425-0100 | 2020-11-05 |
| 1285231340 | Bree Romecki | Nurse Practitioner | 171 Ashley Ave, Charleston, SC 29425-0100 | 2020-10-02 |
| 1942812078 | Warren Allen James | Student in an Organized Health Care Education/Training Program | 171 Ashley Ave, Charleston, SC 29425-8908 | 2020-08-19 |
| 1457962060 | Rosmary Ros-demarize | Psychologist | 171 Ashley Ave, Charleston, SC 29425-0100 | 2020-08-17 |
| 1558971390 | Auryelle Ascue | Nurse Practitioner | 171 Ashley Ave, Charleston, SC 29425-8908 | 2020-08-06 |
| 1396361994 | David Gonzalez | Nurse Practitioner | 171 Ashley Ave, Charleston, SC 29425-8911 | 2020-06-19 |
| 1003432592 | Hannah Burrick | Audiologist | 171 Ashley Ave, Charleston, SC 29425-8903 | 2020-06-19 |
| 1528683562 | Kelsey Renee Full | Emergency Medicine | 171 Ashley Ave, Charleston, SC 29425-0100 | 2020-06-16 |
| 1861017949 | Christina Lee | Anesthesiology | 171 Ashley Ave, Charleston, SC 29425-8908 | 2020-06-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922607217 | Krishna Bhandari | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 10 Mcclennan Banks Drive, 2190-r, Msc 918, Charleston, SC 29425 | 2020-10-19 |
| 1649892456 | Mary Macrae Lynch | Social Worker | 179 Ashley Avenue, Charleston, SC 29425 | 2020-05-14 |
| 1528600053 | Amanda Watts | Physician Assistant | 135 Rutledge Ave. Msc 561, Charleston, SC 29425 | 2019-10-16 |
| 1851945497 | Kacy Wonder | Dentist | 173 Ashley Avenue Room 453 Msc 507, Charleston, SC 29425 | 2019-08-01 |
| 1477114569 | Justin Robert Silverman | Surgery | 169 Ashley Avenue, Room 202 Muh, Msc 333, Charleston, SC 29425 | 2019-06-28 |
| 1740840024 | Tyler Buckley | Surgery | 169 Ashley Ave, Room 202 Main Hospital, Msc333, Charleston, SC 29425 | 2019-06-18 |
| 1366001760 | Rayphael Sebastian Hardy | Internal Medicine | 169 Ashley Avenue Room 202 Main Hospital Msc333, Charleston, SC 29425 | 2019-06-10 |
| 1437718889 | Samar Medani | Internal Medicine | Division of Nephrology, Medical Univ of South Carolina, 96 Jonathan Lucas Street, Room 822, Msc 629, Charleston, SC 29425 | 2019-06-10 |
| 1427617950 | Emily Suzanne Nyers | Internal Medicine | 169 Ashley Ave., Room 202 Main Hospital, Msc 333, Charleston, SC 29425 | 2019-06-09 |
| 1790343564 | Alan Cowei Peh | Psychiatry & Neurology | 169 Ashley Avenue Rm 202, Main Hospital Msc 333, Charleston, SC 29425 | 2019-06-05 |
| Find all providers in zip 29425 | ||||
| Taxonomy Code | 2080N0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Neonatal-Perinatal Medicine |
| A pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366886715 | Katherine Elizabeth Chetta | Pediatrics | 10 Mcclennan Banks Drive Msc915, Charleston, SC 29425-3411 | 2013-04-28 |
| 1063605905 | William B. Pittard IIi | Pediatrics | 135 Rutledge Ave Rm 286, Charleston, SC 29425 | 2007-08-23 |
| 1598708232 | Catherine Partyka | Pediatrics | 9330 Medical Plaza Dr., Trident Medical Center, Charleston, SC 29406 | 2006-06-13 |
| 1649624826 | Raechel Elizabeth Irons | Pediatrics | 165 Ashley Ave, Charleston, SC 29425-0296 | 2016-04-14 |
| 1346583960 | Stephanie Glenn Korff | Pediatrics | 165 Ashley Ave, Msc 917, Charleston, SC 29425-8905 | 2013-04-02 |
| 1184976524 | Sheridan Children's Healthcare Services of South Carolina, P.a. | Pediatrics | 9330 Medical Plaza Dr, Charleston, SC 29406-9104 | 2012-10-10 |
| 1659660496 | Heidi Jo Murphy | Pediatrics | 171 Ashley Ave, Charleston, SC 29425 | 2011-04-01 |
| 1275786188 | University Medical Associates | Pediatrics | 171 Ashley Ave, Charleston, SC 29425-8908 | 2008-10-23 |
| 1184801664 | Alison Kristen Chapman | Pediatrics | 171 Ashley Ave, Charleston, SC 29425-8908 | 2008-01-27 |
| 1881741692 | Julie Ross | Pediatrics | 171 Ashley Ave, Charleston, SC 29425-8908 | 2007-01-04 |
| Find all providers in CHARLESTON | ||||
| City | CHARLESTON |
| Zip Code | 29425 |
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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.