GREGORY S WAGNER (NPI# 1649259011) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649259011 |
| Entity Type | Individual |
| Full Name | GREGORY S WAGNER |
| Credential | CRNA |
| Practice Address |
610 W George Ct Paw Paw MI 49079-1000 |
| Mailing Address |
5623 E Dunbar Rd Monroe MI 48161-9127 |
| Practice Telephone | 7342413891 |
| Practice Fax Number | 7342410014 |
| Mailing Telephone | 7342413891 |
| Mailing Fax Number | 7342410014 |
| Enumeration Date | 2006-01-12 |
| Last Update Date | 2007-07-09 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | 4704123173 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BCBS PIN | 5308758220 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215342423 | Gregory Wagner | Student in an Organized Health Care Education/Training Program | 2601 Ocean Pkwy, Brooklyn, NY 11235-7745 | 2014-06-25 |
| 1750324802 | Gregory P. Wagner | Emergency Medicine | 500 Hospital Dr, Department of Emergency Medicine, Warrenton, VA 20186 | 2006-06-14 |
| Street Address |
610 W GEORGE CT |
| City | PAW PAW |
| State | MI |
| Zip Code | 49079-1000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568441939 | Steven Clingerman | Nurse Anesthetist, Certified Registered | 610 W George Ct, Paw Paw, MI 49079-1000 | 2006-01-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700359387 | Elizabeth Ann Heskett | Social Worker | Bronson Lakeview Family Care, 451 Health Parkway, Suite B, Paw Paw, MI 49079 | 2019-01-07 |
| 1346775269 | Timothy Adli Kanaan | Counselor | 816 E Michigan Ave Ste 103, Paw Paw, MI 49079 | 2017-04-28 |
| 1558655464 | Tamayi Bwititi | Family Medicine | 451 Health Pkwy Ste G, Paw Paw, MI 49079 | 2011-06-08 |
| 1942401047 | Jenny Adina Grunberg | Dentist | 54055 County Rd 653, Paw Paw, MI 49079 | 2007-05-29 |
| 1912058918 | David James Potts | Psychologist | 181 West Michigan Ave Suite 3, Mapleview Consultation Center P.c, Paw Paw, MI 49079 | 2007-01-16 |
| 1760438378 | Starhealth Multi-specialty Group, P.C. Pharmacy | Pharmacist | 451 Health Parkway, Paw Paw, MI 49079 | 2006-05-25 |
| 1528029568 | Jayantilal J Bathani | Pediatrics | 505 Hazen St, Ste 203, Paw Paw, MI 49079 | 2006-03-29 |
| 1548231202 | Gregory Cassidy | Physician Assistant | 125 N Kalamazoo St, #82, Paw Paw, MI 49079 | 2006-01-31 |
| 1649782418 | Amber Bemis | Occupational Therapy Assistant | 801 Hazen Street, Suite C, Paw Paw, MI 49079 | 2017-11-01 |
| 1073047122 | Theresa Arnold | Social Worker | 181 W Michigan Ave Ste 3, Paw Paw, MI 49079 | 2017-04-15 |
| Find all providers in zip 49079 | ||||
| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992741599 | John F Boothby | Nurse Anesthetist, Certified Registered | 408 Hazen St, Paw Paw, MI 49079-1019 | 2006-06-21 |
| 1568441939 | Steven Clingerman | Nurse Anesthetist, Certified Registered | 610 W George Ct, Paw Paw, MI 49079-1000 | 2006-01-12 |
| 1164645388 | Bryan Shawn Parks | Nurse Anesthetist, Certified Registered | 408 Hazen St, Paw Paw, MI 49079-1019 | 2007-04-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023615986 | Toleka Regina Taylor | Nurse Anesthetist, Certified Registered | St. John Macomb Hospital, 11800 East 12 Mile Road, Warren, MI 48093 | 2020-10-05 |
| 1245850957 | Black River Anesthesia Staffing LLC | Nurse Anesthetist, Certified Registered | 7245 Baseline Rd, South Haven, MI 49090-9176 | 2020-04-22 |
| 1669008017 | Kalin Elizabeth Wade | Nurse Anesthetist, Certified Registered | 4485 Kenneth Dr Apt C207, Okemos, MI 48864-1900 | 2020-03-18 |
| 1215568340 | Complete Ketamine Inc | Nurse Anesthetist, Certified Registered | 98 Winchester St, Monroe, MI 48161-1957 | 2020-01-28 |
| 1730729740 | Pride Mudzwova | Nurse Anesthetist, Certified Registered | 57693 Dakota Dr, New Hudson, MI 48165-9336 | 2020-01-08 |
| 1982249041 | Leif Elias | Nurse Anesthetist, Certified Registered | 3443 Oak Dr, Ann Arbor, MI 48105-9798 | 2019-11-13 |
| 1619512779 | Yvonne Marie Bridgeford | Nurse Anesthetist, Certified Registered | 2113 Mason Rd, Howell, MI 48843-8903 | 2019-11-13 |
| 1184269243 | Jaclyn Rochefort | Nurse Anesthetist, Certified Registered | 5381 Frovan Pl, Saginaw, MI 48638-5573 | 2019-11-13 |
| 1932744091 | Sean S Vanderwaal | Nurse Anesthetist, Certified Registered | 1420 Perry Rd Apt 1-8, Grand Blanc, MI 48439-1727 | 2019-11-13 |
| 1467093153 | Apollo Medical Group of Traverse City Pllc | Nurse Anesthetist, Certified Registered | 3663 N Country Dr, Traverse City, MI 49684-4587 | 2019-10-03 |
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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.