DAVID WAGNER (NPI# 1669690863) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669690863 |
| Entity Type | Individual |
| Full Name | DAVID WAGNER |
| Credential | LADC |
| Practice Address |
2086 Ridgeway Dr Grand Rapids MN 55744-4421 |
| Mailing Address |
2632 County Road 444 Hibbing MN 55746-8106 |
| Practice Telephone | 2183279944 |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
301160 | MN | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538236757 | David Michael Wagner | Counselor | 8335 40th Ave N, St Petersburg, FL 33709-3934 | 2006-11-30 |
| 1912079823 | David A Wagner Sr. | Dentist | 43 East Mills Street, Columbus, NC 28722 | 2006-11-15 |
| 1205917523 | David Wagner | Dentist | 1919 N Pearl St Ste A3, Tacoma, WA 98406-2456 | 2006-10-17 |
| 1255444345 | David Robert Wagner | Chiropractor | 3107 W Slaughter Ln, Austin, TX 78748-5574 | 2006-08-16 |
| 1265448328 | David C Wagner | Physical Therapist | 3105 Main St, Marlette, MI 48453-1508 | 2006-07-31 |
| 1821012105 | David Wagner | Internal Medicine | 135 East 37th St, New York, NY 10016 | 2006-07-27 |
| 1295754778 | David A Wagner | Optometrist | 3285 State Route 257, Seneca, PA 16346-2529 | 2006-07-18 |
| 1508847997 | David Scott Wagner | Chiropractor | 31285 Temecula Pkwy Ste 260, Temecula, CA 92592-6830 | 2005-11-11 |
| 1821085168 | David Edwin Wagner | Dentist | 5992 Howdershell Rd, Ste 206, Hazelwood, MO 63042-4107 | 2005-10-03 |
| 1326046897 | David Gordon Wagner | Specialist | 14955 Shady Grove Rd, Suite 125, Rockville, MD 20850-8700 | 2005-07-08 |
| Street Address |
2086 RIDGEWAY DR |
| City | GRAND RAPIDS |
| State | MN |
| Zip Code | 55744-4421 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851496368 | Hope House of Itasca County, Inc. | Substance Abuse Rehabilitation Facility | 2086 Ridgeway Dr, Grand Rapids, MN 55744-4421 | 2006-09-13 |
| 1124549571 | Kate R. Makinen | Counselor | 2086 Ridgeway Dr, Grand Rapids, MN 55744-4421 | 2017-07-06 |
| 1225357437 | Pear Lake Women's Facility - Outpatient | Counselor | 2086 Ridgeway Dr, Grand Rapids, MN 55744-4421 | 2010-05-27 |
| 1063730737 | Christina Smith | Counselor | 2086 Ridgeway Dr, Grand Rapids, MN 55744-4421 | 2010-05-05 |
| 1336367531 | Iris L Senogles | Counselor | 2086 Ridgeway Dr, Grand Rapids, MN 55744-4421 | 2007-04-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710587696 | Friesen & Friesen, Inc | Assisted Living Facility | 1971 Ne 1st Avenue, Grand Rapids, MN 55744 | 2020-10-29 |
| 1699392555 | Duane Stanley Helmer | Counselor | First Call for Help of Itasca County, 1707 Nw 4th Street Suite B, Grand Rapids, MN 55744 | 2020-06-26 |
| 1821631391 | Patrice Marie Curtiss | Technician | 23792 Winckler Road, Grand Rapids, MN 55744 | 2019-10-28 |
| 1578117438 | Christina Marie Hubred | Advanced Practice Dental Therapist | Miskovich Dental Clinic, 1121 Se 4th Avenue, Grand Rapids, MN 55744 | 2019-07-30 |
| 1780081877 | Fcsl Grand Rapids, LLC | Assisted Living Facility | 949 1/2 Sw 11th Street, Grand Rapids, MN 55744 | 2014-12-04 |
| 1912311333 | Doctor V LLC | Psychologist | 2002 Cromell Drive, Hope House of Itasca County, Laprairie, MN 55744 | 2014-06-13 |
| 1104244987 | Linda Reinen-thompson | Contractor | 34307 Hwy. 38, Grand Rapids, MN 55744 | 2014-03-31 |
| 1275883266 | Lana Rae Jacobson | Registered Nurse | 1401 Nw 9th Street, Grand Rapids, MN 55744 | 2012-09-17 |
| 1518252048 | David Allen Griggs | Pharmacist | 2140 S.pokegama Ave., T-0904, Target, Grand Rapids, MN 55744 | 2011-06-13 |
| 1447575063 | Kelly Ann Shermoen | Pharmacist | 18 Se 10th Street, Grand Rapids, MN 55744 | 2010-04-07 |
| Find all providers in zip 55744 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891302717 | Paige J Welch | Counselor | 1509 Diamond Ave Ne, Grand Rapids, MI 49505-5217 | 2020-09-24 |
| 1588277040 | Gregory Dean Retzlaff | Counselor | 2043 Rowe Ave Ne, Grand Rapids, MI 49505-4238 | 2020-08-25 |
| 1699392555 | Duane Stanley Helmer | Counselor | First Call for Help of Itasca County, 1707 Nw 4th Street Suite B, Grand Rapids, MN 55744 | 2020-06-26 |
| 1649779927 | Larry Mitchell | Counselor | 1960 Millbrook St Se, Grand Rapids, MI 49508-2636 | 2018-02-01 |
| 1235657388 | Courtney Albin | Counselor | 2504 Ardmore St Se Ste 202b, Grand Rapids, MI 49506-4901 | 2017-09-08 |
| 1649712001 | Alexander C Meyer | Counselor | 1200 S Pokegama Ave Ste 160, Grand Rapids, MN 55744-4296 | 2016-11-15 |
| 1871048934 | Nicole Nutt | Counselor | 32 Winter Ave Sw Apt 228, Grand Rapids, MI 49504-6488 | 2016-08-18 |
| 1306247564 | Krystal Strotbaum | Counselor | 5242 Plainfield Ave Ne Ste E, Grand Rapids, MI 49525-1084 | 2014-09-08 |
| 1710390372 | Laura Meeker Wicksall | Counselor | 1430 Robinson Rd Se Ste 206, Grand Rapids, MI 49506-1723 | 2014-06-11 |
| 1023358314 | Carole Lynn Walters | Counselor | 959 Wealthy St Se, Grand Rapids, MI 49506-2519 | 2013-02-22 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 55744 |
Please comment or provide details below to improve the information on DAVID WAGNER.
| 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.