DR. TREVOR JOHN WAGNER (NPI# 1740229566) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740229566 |
| Entity Type | Individual |
| Full Name | DR. TREVOR JOHN WAGNER |
| Credential | D.C. |
| Practice Address |
2639 S 159th Plz Omaha NE 68130-1705 |
| Mailing Address |
6411 S 172nd Ave Omaha NE 68135-3080 |
| Practice Telephone | 4023344700 |
| Practice Fax Number | 4023340891 |
| Mailing Telephone | 4028911249 |
| Mailing Fax Number | 4023340891 |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111NS0005X |
Chiropractor Specialization: Sports Physician |
1125 | NE | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NE | BLUE CROSS/BLUE SHIELD | 36615 | 01 |
| NE | 47-0802260 05 | 05 |
| Street Address |
2639 S 159TH PLZ |
| City | OMAHA |
| State | NE |
| Zip Code | 68130-1705 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760437099 | Julie Elizabeth Owen-wagner | Chiropractor | 2639 S 159th Plz, Omaha, NE 68130-1705 | 2006-05-24 |
| 1801982806 | Wagner Chiropractic Clinic, PC | Chiropractor | 2639 S 159th Plz, Omaha, NE 68130-1705 | 2006-10-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861998270 | Samantha June Curto | Nurse Practitioner | 17021 Lakeside Drive, Suite 200, Omaha, NE 68130 | 2018-04-04 |
| 1780196451 | Heritage Oncare Home Health LLC | Home Health | 16934 Frances St Ste 200, Omaha, NE 68130 | 2017-11-02 |
| 1497281745 | Dental Professionals of Nebraska, PC | Dentist | 17810 Pierce Plaza, Suite 100, Omaha, NE 68130 | 2017-05-05 |
| 1891166492 | Stephanie Tupper | Speech-Language Pathologist | 16338 Oak Circle, Omaha, NE 68130 | 2015-10-08 |
| 1194036723 | Anthony John Macdissi | Internal Medicine | 16901 Lakeside Hills Court, Attn: Hospital Medicine Dept., Omaha, NE 68130 | 2010-06-29 |
| 1568613305 | Kelly Marie Barkmeier | Occupational Therapist | 1906 South 196th Street, Omaha, NE 68130 | 2008-10-09 |
| 1306009758 | Melissa Sue Loseke | Family Medicine | 17021 Lakeside Hills Plz #200, Omaha, NE 68130 | 2008-07-07 |
| 1477724417 | Denise L. Pollard | Nurse Practitioner | 17525 Gold Plaza Ste 116, Omaha, NE 68130 | 2008-03-18 |
| 1508053943 | Omaha Family Medicine, P.C. | Family Medicine | 17841 Pierce Plz, Omaha, NE 68130 | 2007-10-01 |
| 1669672523 | Jennifer L Liu | Family Medicine | 16909 Lakeside Hills, Ste 300, Omaha, NE 68130 | 2007-07-19 |
| Find all providers in zip 68130 | ||||
| Taxonomy Code | 111NS0005X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| Specialization | Sports Physician |
| A sports chiropractor is uniquely trained to provide care and treatment of injuries or illness resulting from sports and physical fitness activities. Doctors of Chiropractic with the Diplomate American Chiropractic Board of Sports Physicians (DACBSP) or the Certified Chiropractic Sports Physician (CCSP), sport specialty certifications from the American Chiropractic Board of Sports Physicians, have advanced training in the assessment, management and rehabilitation of sports related injuries. Extremity care, rehabilitation and soft tissue procedures are common skills utilized by these doctors. The specialty training covers a broad spectrum from the pediatric athlete to professional and Olympic athletes, and everything in between, using a variety of techniques and modalities. |
| Notes: Source: American Chiropractic Board of Sports Physicians, 2009 [7/1/2009: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952831570 | Adam Freeman | Chiropractor | 3605 North 147th Street, Suite 106, Omaha, NE 68116 | 2017-06-15 |
| 1306192331 | Charles Joseph Holcomb | Chiropractor | 6918 Maple St, Omaha, NE 68104-3839 | 2012-07-27 |
| 1801278247 | Holcomb Chiropractic LLC | Chiropractor | 6918 Maple St, Omaha, NE 68104-3839 | 2015-06-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588825764 | Dr Dan L Mosier PC | Chiropractor | 4645 Normal Blvd Ste 200, Lincoln, NE 68506-5823 | 2008-06-20 |
| 1114942406 | Gregory D Hoogeveen | Chiropractor | 1301 Fort Crook Rd S, Bellevue, NE 68005-2940 | 2006-07-13 |
| 1902874274 | Scott Gene Johnson | Chiropractor | 279 Main St, Chadron, NE 69337-2355 | 2006-03-10 |
| 1043257504 | Chadron Chiropractic, P.C. | Chiropractor | 279 Main St, Chadron, NE 69337-2355 | 2006-06-01 |
| 1215923602 | Reggie Lauer Clifton | Chiropractor | 2501 Capehart Rd, Offutt A F B, NE 68113-1043 | 2005-09-21 |
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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.