MRS. JESSICA LACHELLE WAGNER GREGG


Address: 22 S Greene St, Baltimore, MD 21201-1590
Phone: 4103288667

MRS. JESSICA LACHELLE WAGNER GREGG (NPI# 1033740980) 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) 1033740980
Entity Type Individual
Full Name MRS. JESSICA LACHELLE WAGNER GREGG
Other Name MS. JESSICA LACHELLE WAGNER
Credential MSN, CRNP, CPNP-AC
Practice Address 22 S Greene St
Baltimore
MD 21201-1590
Mailing Address 621 S Paca St
Baltimore
MD 21230-2411
Practice Telephone 4103288667
Mailing Telephone 5616857782
Enumeration Date 2020-01-29
Last Update Date 2020-01-29
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2080P0203X Pediatrics
Specialization: Pediatric Critical Care Medicine
AC002979 MD Allopathic & Osteopathic Physicians

Office Location

Street Address 22 S GREENE ST
City BALTIMORE
State MD
Zip Code 21201-1590

Providers in the same location

NPI Name Taxonomy Address Enumeration
1750383063 Malinda Daniel Duke Nurse Practitioner 22 S Greene St, Rm N6w84, Baltimore, MD 21201-1544 2005-06-01
1891396784 Tamara Wiseman Nurse Practitioner 22 S Greene St, Baltimore, MD 21201-1544 2020-11-05
1063012664 Shawna Marie Hutton Registered Nurse 22 S Greene St, Baltimore, MD 21201-1590 2020-11-01
1124625413 Kerry Ann Lambert Pharmacist 22 S Greene St, Baltimore, MD 21201-1590 2020-10-08
1730786104 Joseph William Russo Pediatrics 22 S Greene St, Baltimore, MD 21201-1590 2020-10-07
1295342327 Leah Marie Dubose Nurse Practitioner 22 S Greene St, Baltimore, MD 21201-1544 2020-09-23
1275147167 Rosalynn Joy Allen Registered Nurse 22 S Greene St, Baltimore, MD 21201-1590 2020-09-08
1174137269 Keiara Williams Nurse Practitioner 22 S Greene St, Baltimore, MD 21201-1544 2020-09-04
1699389858 Caitlin Lauren Thomas Nurse Practitioner 22 S Greene St, Baltimore, MD 21201-1544 2020-09-04
1639782568 Anna Pfouts Nurse Practitioner 22 S Greene St, Baltimore, MD 21201-1544 2020-08-29
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1518585470 Meshref Ayed Alshehri Student in an Organized Health Care Education/Training Program 22 S. Greene Street, Room N3e09, Baltimore, MD 21201 2020-07-08
1306462411 Michael Julian Wong Student in an Organized Health Care Education/Training Program University of Maryland, Department of Anesthesiology, 22 S Green St, S11b, Baltimore, MD 21201 2020-06-24
1740817733 Martha Kaitlyn Coghlan Student in an Organized Health Care Education/Training Program Ummc Ob/gyn, 22 S. Greene St., Baltimore, MD 21201 2020-03-27
1629606637 Taylor Renee Kai Student in an Organized Health Care Education/Training Program University of Maryland, 22 S. Greene Street, Room N3e09, Baltimore, MD 21201 2020-03-27
1295362697 Brittany A Oster Student in an Organized Health Care Education/Training Program 110 S. Paca Street 6th Floor, Suite 300, Baltimore, MD 21201 2020-03-25
1346877735 Kayvon Michael Mobarakeh Student in an Organized Health Care Education/Training Program University of Maryland Department of Anesthesiology, 22 S Greene St, S11c, Baltimore, MD 21201 2020-03-25
1598392284 Zachary Allan Hagen Student in an Organized Health Care Education/Training Program 110 S. Paca Street, 6th Flr., Suite 200, Baltimore, MD 21201 2020-03-24
1700430055 Jaime Semchuk Student in an Organized Health Care Education/Training Program 737 West Lombard, Baltimore, MD 21201 2019-07-25
1952861619 Zachary Daniel Sanford Student in an Organized Health Care Education/Training Program 22 S Greene Street S8b12, Baltimore, MD 21201 2019-03-20
1114487840 Spencer Sykes Lovegrove Student in an Organized Health Care Education/Training Program 110 S. Paca Street, Sixth Floor, Suite 200, Baltimore, Sixth Floor, Suite 200, Baltimore, MD 21201 2019-03-20
Find all providers in zip 21201

Taxonomy Information

Taxonomy Code 2080P0203X
Grouping Allopathic & Osteopathic Physicians
Classification Pediatrics
Specialization Pediatric Critical Care Medicine

Taxonomy Definition

A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. ACGME Accredited Residency Program Requirements: 2 years of training with 3 years Pediatrics plus 1 year Pediatric Critical Care for certification for a total of 6 years. ABMS Approved Subspecialty Certificate (Pediatrics)

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1316572175 Sarah Branigan Pediatrics Johns Hopkins Children's Center, 1800 Orleans Street, Baltimore, MD 21287 2020-03-11
1891333969 Jaime Esbensen Doroba Pediatrics 1800 Orleans St, Baltimore, MD 21287-0010 2019-12-19
1083032346 Marie Emeline Pierre Louis Pediatrics 2401 W Belvedere Ave, Baltimore, MD 21215-5216 2014-04-03
1316280001 Natalie S Torres-feliz Pediatrics 22 S Greene St, Baltimore, MD 21201-1544 2013-04-01
1346545183 Osei Kofi Owusu Pediatrics 2401 W Belvedere Ave, Baltimore, MD 21215-5216 2011-01-25
1508009291 Elizabeth Winans Tucker Pediatrics 1800 Orleans St, Baltimore, MD 21287-0010 2009-04-11
1902077555 Chinyere Egbuta Pediatrics 600 N Wolfe St, Baltimore, MD 21287-0005 2008-03-21
1366571697 Steven R Coleman Pediatrics 22 S Greene St, Baltimore, MD 21201-1544 2007-03-04
1194862102 Melania M Bembea Pediatrics 600 N Wolfe St, Blalock 904, Baltimore, MD 21287-0005 2007-01-31
1972649465 Jason Wayne Custer Pediatrics 22 S Greene St, Dept of Pediatric Critical Care Medicine, Baltimore, MD 21201-1544 2007-01-30
Find all providers in BALTIMORE

Competitor

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City BALTIMORE
Zip Code 21201

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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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