MICHAEL C WAGNER II (NPI# 1073655825) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073655825 |
| Entity Type | Individual |
| Full Name | MICHAEL C WAGNER II |
| Credential | FNP |
| Practice Address |
603 N Logan Ave Danville IL 61832-4320 |
| Practice Telephone | 2172135254 |
| Practice Fax Number | 2172135240 |
| Mailing Telephone | 2172135254 |
| Mailing Fax Number | 2172135240 |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2010-11-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
209003483 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700446267 | Michael Wagner | Dentist | 754 S Main St Ste 1, St George, UT 84770-5510 | 2019-06-17 |
| 1336655034 | Michael D Wagner | Custodial Care Facility | 807 Pine Ave Nw, Grand Rapids, MI 49504-4340 | 2017-12-18 |
| 1285169037 | Michael Wagner | Student in an Organized Health Care Education/Training Program | 4316 E Avalon Dr, #11, Phoenix, AZ 85018-7245 | 2017-04-28 |
| 1235585191 | Michael Charles Wagner | Occupational Therapist | 170 2nd St S, Nampa, ID 83651-3708 | 2016-05-10 |
| 1033555362 | Michael S Wagner | Marriage & Family Therapist | 3263 Sacramento St, Suite B, San Francisco, CA 94115-2054 | 2013-05-14 |
| 1013154293 | Michael James Wagner | Counselor | 10207 E Shady Rock Ln, Tucson, AZ 85749-8162 | 2009-01-09 |
| 1619159084 | Michael Paul Wagner | Chiropractor | 544e. North Ave, Glendale Heights, IL 60139 | 2007-11-28 |
| 1609903178 | Michael John Wagner | Dentist | 13515 Ne 175th St Ste G, Woodinville, WA 98072-8566 | 2007-02-28 |
| 1760577340 | Michael Dale Wagner | Psychologist | 5415 Medallion Dr W, Westerville, OH 43082-9194 | 2006-10-03 |
| 1083719942 | Michael E Wagner | Chiropractor | 8553 Hickman Rd, Urbandale, IA 50322-4321 | 2006-09-14 |
| Street Address |
603 N LOGAN AVE |
| City | DANVILLE |
| State | IL |
| Zip Code | 61832-4320 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558665596 | Central Illinois Family Practice | Nurse Practitioner | 603 N Logan Ave, Danville, IL 61832-4320 | 2011-01-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316593957 | Margaret Jean Heath | Technician | 310 N North St, Danville, IL 61832 | 2019-08-09 |
| 1215494620 | Osf Multi-specialty Group | Non-Pharmacy Dispensing Site | 3653 N Vermilion Dr, Danville, IL 61832 | 2019-02-22 |
| 1003263104 | Bayview Family Clinic | Nurse Practitioner | 3595 N Vermillion Street, Danville, IL 61832 | 2016-05-18 |
| 1194179499 | Kinisha Vasser | Social Worker | 1900 E. Main Steet, Danville, IL 61832 | 2016-04-22 |
| 1023497237 | Alpha Omega Counseling Services | Community/Behavioral Health | 120 N Vermilion, Danville, IL 61832 | 2015-05-20 |
| 1437557568 | Terri D. Dunn | Hearing Instrument Specialist | 733 N. Logan #4, Audibel Hearing Aids, Danville, IL 61832 | 2014-12-05 |
| 1518361682 | Rosemarie Renee Eck | Nurse Practitioner | 1900 E Main St, Bldg 101-171, Va Illiana Health Care System, Danville, IL 61832 | 2014-10-17 |
| 1497181747 | Usv Optical Inc. | Eyewear Supplier (Equipment, not the service) | 3649 N. Vermillion St., Danville, IL 61832 | 2013-09-18 |
| 1598000770 | Bayview Family Clinic Ltd | Health Maintenance Organization | 405 N. Sheridan St., Danville, IL 61832 | 2012-11-29 |
| 1992052666 | Katharine Lorraine Lerner | Pharmacist | 3649 N Vermilion St, Danville, IL 61832 | 2012-08-13 |
| Find all providers in zip 61832 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124626585 | Dustin Mikesell | Nurse Practitioner | 1000 E Main St Ste 104, Danville, IN 46122-1948 | 2020-10-16 |
| 1356958565 | Kenneth Neal Hawker Jr. | Nurse Practitioner | 136 Capri Ct, Danville, VA 24541-5116 | 2020-09-30 |
| 1134752546 | Jeanette Marie Hay | Nurse Practitioner | 7 Manor Dr Ste B, Danville, IN 46122-9402 | 2020-02-14 |
| 1194297853 | Maurice Roberts | Nurse Practitioner | Godocs LLC, 949 Piney Forest Road, Danville, VA 24540-1591 | 2018-12-19 |
| 1811465461 | Amelia Brown | Nurse Practitioner | 101 Citation Dr Ste C, Danville, KY 40422-9227 | 2018-11-12 |
| 1326529827 | Danville Medical Specialty | Nurse Practitioner | 504 Tenikat St, Danville, KY 40422-1751 | 2018-08-23 |
| 1528548328 | Abby Young | Nurse Practitioner | Danville Health Center, 26 Cedar Ln, Danville, VT 05828-0185 | 2018-08-21 |
| 1730668377 | Kristen Chilton Grabowski | Nurse Practitioner | 125 Executive Dr Ste J, Danville, VA 24541-4155 | 2018-08-13 |
| 1447761952 | April Yeatts Giles | Nurse Practitioner | 404 Airport Dr Ste A, Danville, VA 24540-5196 | 2017-10-24 |
| 1467970715 | Amelia Nicole Stevens I | Nurse Practitioner | 478 Whirlaway Dr Ste 200, Danville, KY 40422-9037 | 2017-09-07 |
| Find all providers in DANVILLE | ||||
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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.