DIANE JORDAN-WAGNER


Address: 1429 N 6th St, Terre Haute, IN 47804-1037
Phone: 8122320564

DIANE JORDAN-WAGNER (NPI# 1013025097) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1013025097
Entity Type Individual
Full Name DIANE JORDAN-WAGNER
Credential M.D.
Practice Address 1429 N 6th St
Terre Haute
IN 47804-1037
Mailing Address 221 S 6th St
Terre Haute
IN 47807-4214
Practice Telephone 8122320564
Practice Fax Number 8122353330
Mailing Telephone 8122320564
Mailing Fax Number 8122353330
Enumeration Date 2006-08-29
Last Update Date 2013-03-14
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207RA0201X Internal Medicine
Specialization: Allergy & Immunology
36106006 IL Allopathic & Osteopathic Physicians
Y 207RA0201X Internal Medicine
Specialization: Allergy & Immunology
01056292A IN Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
ANTHEM 000000230225 01
IN RAILROAD MEDICARE P00844293 01
IN 200392780Q 05
IN 200392780 05
RAILROAD MCARE PALAMETTO 030005377 01

Office Location

Street Address 1429 N 6TH ST
City TERRE HAUTE
State IN
Zip Code 47804-1037

Providers in the same location

NPI Name Taxonomy Address Enumeration
1396749966 Karen Ann Tisinai Surgery 1429 N 6th St, Terre Haute, IN 47807-1037 2005-06-10
1497362438 Loganne D Wertz Physician Assistant 1429 N 6th St, Terre Haute, IN 47807-1019 2020-09-24
1346861788 Marcy Aldrich Nurse Practitioner 1429 N 6th St, Terre Haute, IN 47807-1019 2020-04-27
1538798210 Bernice Imogene Morris Nurse Practitioner 1429 N 6th St, Terre Haute, IN 47807-1019 2020-04-05
1760043566 Alexandra Strunk Physician Assistant 1429 N 6th St, Terre Haute, IN 47807-1019 2019-06-24
1366917965 Rebecca Proctor Nurse Practitioner 1429 N 6th St, Terre Haute, IN 47807-1019 2018-10-10
1326535816 Kindra Lee Shepard Nurse Practitioner 1429 N 6th St, Terre Haute, IN 47807-1019 2018-04-19
1992150965 Jennifer Gruber Nurse Practitioner 1429 N 6th St, Terre Haute, IN 47807-1019 2016-04-27
1821467689 Sarah Kachman Nurse Practitioner 1429 N 6th St, Terre Haute, IN 47807-1019 2015-09-22
1538572862 Mohammed Zaher Urology 1429 N 6th St, Terre Haute, IN 47807-1019 2014-06-04
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1568971885 Tiffany Marshall Physical Therapist North At Uap Bone & Joint Center, Lower Level 1725 North 5th Street, Terre Haute, IN 47804 2017-09-29
1336565423 Deondra Allison Cottrill Physical Therapy Assistant 1725 N. 5th Street, Union Hospital Therapy Services, Terre Haute, IN 47804 2014-03-13
1043635170 Patricia Klos Physical Therapy Assistant 1606 Nth 7th Street, Terre Haute, IN 47804 2014-02-26
1043565476 Debra Denehie Hills Registered Nurse 620 8th Avenue, Terre Haute, IN 47804 2012-07-23
1841503257 Meredeth Su Gray Dentist 1608 Lafayette Avenue, Terre Haute, IN 47804 2010-07-15
1083946628 John Barton, Lpt Health Maintenance Organization 1818 N 3rd Street, Terre Haute, IN 47804 2010-02-08
1750584009 Kool Smiles In-3, PC Dentist 1800 Fort Harrison Rd, Terra Haute, IN 47804 2007-06-06
1619006988 Union Hospital Inc Student in an Organized Health Care Education/Training Program 1513 N 6 1-2 Street, Terre Haute, IN 47804 2007-03-05
1730243080 John Lee Nichols Dentist 1246 Maple Ave, Terre Haute, IN 47804 2006-12-21
1093894057 Isaac N Mitre Obstetrics & Gynecology 1623 N 4th Street, Terre Haute, IN 47804 2006-11-02
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Taxonomy Information

Taxonomy Code 207RA0201X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Allergy & Immunology

Taxonomy Definition

An internist doctor of osteopathy that specializes in the treatment of allergy and immunologic disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Special Qualifications in the field of Allergy & Immunology.
Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: added definition, added source; 7/1/2011: modified source]
- Additional Resources: http://www.osteopathic.org/certification

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1962586198 Associated Physicians & Surgeons Clinic, LLC Internal Medicine 1739 N 4th St, Terre Haute, IN 47804-4002 2006-10-24
1023107869 Associated Physicians & Surgeons Clinic, LLC Internal Medicine 4601 S 7th St, Terre Haute, IN 47802-4522 2006-10-12

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1992229199 Baki.l.l.c Internal Medicine 786 Mccool Rd Ste 6, Valparaiso, IN 46385-8894 2017-07-29
1043339005 Joseph Nelson Gaddy Internal Medicine 2525 N Shadeland Ave, Suite105, Indianapolis, IN 46219-1787 2007-03-28
1780669374 Douglas A. Neeld Internal Medicine 3828 New Vision Drive, Fort Wayne, IN 46845 2005-12-07
1679781314 Southside Pulmonary & Sleep Consultants, LLC Internal Medicine 1040 Greenwood Springs Blvd, Greenwood, IN 46143-7975 2007-05-18
1932299633 Associated Physicians & Surgeons Clinic, LLC Internal Medicine 700 S Main St, Clinton, IN 47842-2420 2006-10-13
1578529046 William H Baker Internal Medicine 550 University Blvd, 111p, Indianapolis, IN 46202-5149 2006-04-25
1447229380 Pulmonary Asthma & Allergy Consults Internal Medicine 2510 E Dupont Rd, Ste 200, Fort Wayne, IN 46825 2006-03-14
1932198488 Robert W Clausen Internal Medicine 211 N Eddy St, South Bend, IN 46617-2808 2005-10-18

Competitor

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City TERRE HAUTE
Zip Code 47804

Improve Information

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Dataset Information

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.

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