KELLY WAGNER (NPI# 1154776334) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154776334 |
| Entity Type | Individual |
| Full Name | KELLY WAGNER |
| Practice Address |
100 High St C 378 Buffalo NY 14203-1126 |
| Practice Telephone | 7168597755 |
| Enumeration Date | 2016-04-26 |
| Last Update Date | 2016-04-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013570746 | Kelly Susan Wagner | Speech-Language Pathologist | 8902 Old Harford Rd, Baltimore, MD 21234-2646 | 2019-04-18 |
| 1356808455 | Kelly Mcmahon Wagner | Social Worker | 4701 Greenspring Ave, Baltimore, MD 21209-4704 | 2019-02-25 |
| 1659744316 | Kelly Ann Wagner | Nurse Practitioner | 10410 Abercorn Expressway, Savannah, GA 31419 | 2015-11-03 |
| 1659612745 | Kelly Ann Wagner | Specialist | 727 Carmen Dr, Norristown, PA 19401-3545 | 2013-03-14 |
| 1881925592 | Kelly Danielle Wagner | Physical Therapy Assistant | 226 Fish Hall Rd, Brunswick, GA 31523-7405 | 2010-01-20 |
| 1407180268 | Kelly Ann Wagner | Licensed Practical Nurse | 1143 Vogt Dr Apt 14, West Bend, WI 53095-5505 | 2009-09-28 |
| 1295288629 | Kelly Wagner | Dietitian, Registered | 200 Hawkins Dr, Food and Nutrition Services, W146 Gh, Iowa City, IA 52242-1009 | 2016-08-02 |
| 1346613205 | Kelly Wagner | Naturopath | 185 Tilley Dr, Suite #51, South Burlington, VT 05403-4484 | 2015-11-01 |
| 1932510831 | Kelly Wagner | Pharmacist | 3360 Tittabawassee Rd, Saginaw, MI 48604-9453 | 2014-05-13 |
| 1235562307 | Kelly Anne Wagner | Speech-Language Pathologist | 331 E Park St, Weiser, ID 83672-2053 | 2013-08-13 |
| Street Address |
100 HIGH ST C 378 |
| City | BUFFALO |
| State | NY |
| Zip Code | 14203-1126 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093712077 | Kristen M Salvamoser | Physician Assistant | 100 High St, Buffalo, NY 14203-1126 | 2005-07-05 |
| 1801401765 | Sheena Deering | Nurse Practitioner | 100 High St, Buffalo, NY 14203-1126 | 2020-09-08 |
| 1528679321 | Sarah E Hinterberger | Nurse Practitioner | 100 High St, Buffalo, NY 14203-1126 | 2020-08-14 |
| 1841801537 | Amanda Scafetta | Nurse Practitioner | 100 High St, Buffalo, NY 14203-1126 | 2020-08-14 |
| 1023629938 | Ashlie Graham | Nurse Practitioner | 100 High St, Buffalo, NY 14203-1126 | 2020-08-13 |
| 1740800747 | Brian Girard | Student in an Organized Health Care Education/Training Program | 100 High St, Buffalo, NY 14203-1126 | 2020-04-20 |
| 1558981761 | Jule Deren | Student in an Organized Health Care Education/Training Program | 100 High St, Buffalo, NY 14203-1126 | 2020-04-17 |
| 1164041505 | Matthew Jon Peterson | Student in an Organized Health Care Education/Training Program | 100 High St, Buffalo, NY 14203-1126 | 2020-04-15 |
| 1679192249 | Garrett Skinner | Student in an Organized Health Care Education/Training Program | 100 High St, Buffalo, NY 14203-1126 | 2020-04-13 |
| 1245859065 | Kenan Rodwan Rajjoub | Student in an Organized Health Care Education/Training Program | 100 High St, Buffalo, NY 14203-1126 | 2020-04-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912514902 | Valerie Anne Conley | Counselor | 475 Elllicott St., Buffalo, NY 14203 | 2020-09-24 |
| 1457975674 | Qing Ma | Pharmacist | Nys Center of Excellence In Bioinformatics and Life Sci, 701 Ellicott Street, Buffalo, NY 14203 | 2020-06-03 |
| 1265056659 | Elizabeth Nicole Mancuso | Student in an Organized Health Care Education/Training Program | 1001 Main Street University At Buffalo, Department of P, 5th Floor, Buffalo, NY 14203 | 2020-06-02 |
| 1720601404 | Ronak Dhiraj Bahuva | Student in an Organized Health Care Education/Training Program | 955 Main Street, University At Buffalo, Jacobs School O, Buffalo, NY 14203 | 2020-05-28 |
| 1780207266 | Jaya Mishra | Student in an Organized Health Care Education/Training Program | 818 Ellicot Street, Buffalo, NY 14203 | 2020-05-19 |
| 1013530617 | Amanpreet Kaur Singh | Student in an Organized Health Care Education/Training Program | 77 Goodell Street Department of Medicine, Suite 240, Buffalo, NY 14203 | 2020-05-19 |
| 1013538917 | Leen Hosam Alyacoub | Student in an Organized Health Care Education/Training Program | 100 High Street, D2-76 Buffalo, Ny 14203, Buffalo Gener, Buffall, NY 14203 | 2020-05-01 |
| 1003436601 | Maxiam Dean | Student in an Organized Health Care Education/Training Program | Ub Family Residency Program, 77 Goodell Street, 2nd Floor, Buffalo, NY 14203 | 2020-04-23 |
| 1144849837 | Jennifer Anthone-kloss | Student in an Organized Health Care Education/Training Program | Anesthesiology Residency & Fellowship Programs, Ub Gateway, 77 Goodell Street, Suite 550, Buffalo, NY 14203 | 2020-04-13 |
| 1821658873 | Peter William Ip Fung Chun | Student in an Organized Health Care Education/Training Program | 1001 Main Street, Room 5145, Division of Pediatric Medical Education, Buffalo, NY 14203 | 2019-06-20 |
| Find all providers in zip 14203 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427655273 | Daniel Edwards | Student in an Organized Health Care Education/Training Program | 52 Angle St Uppr, Buffalo, NY 14214-1139 | 2020-10-05 |
| 1497366413 | Krista Lea Marita Koskinen | Student in an Organized Health Care Education/Training Program | 462 Grider Street, 11th Floor, Erie County Medical Cent, Buffalo, NY 14215 | 2020-08-13 |
| 1851919112 | Temitope Oluwaseun Ajayi | Student in an Organized Health Care Education/Training Program | 132 Affinity Lane, Buffalo, NY 14215 | 2020-07-13 |
| 1265056659 | Elizabeth Nicole Mancuso | Student in an Organized Health Care Education/Training Program | 1001 Main Street University At Buffalo, Department of P, 5th Floor, Buffalo, NY 14203 | 2020-06-02 |
| 1356964043 | Andrew Buck | Student in an Organized Health Care Education/Training Program | 3435 Main St # 119, Buffalo, NY 14214-3001 | 2020-05-28 |
| 1720601404 | Ronak Dhiraj Bahuva | Student in an Organized Health Care Education/Training Program | 955 Main Street, University At Buffalo, Jacobs School O, Buffalo, NY 14203 | 2020-05-28 |
| 1780207266 | Jaya Mishra | Student in an Organized Health Care Education/Training Program | 818 Ellicot Street, Buffalo, NY 14203 | 2020-05-19 |
| 1013530617 | Amanpreet Kaur Singh | Student in an Organized Health Care Education/Training Program | 77 Goodell Street Department of Medicine, Suite 240, Buffalo, NY 14203 | 2020-05-19 |
| 1346862935 | Hafiz Muhammad Fazeel | Student in an Organized Health Care Education/Training Program | 2157 Main Street Sisters Hospital Department of Medicin, Buffalo, NY 14214 | 2020-05-18 |
| 1134741986 | Alexandra Lucia Tibil | Student in an Organized Health Care Education/Training Program | 462 Grider Street, Erie County Medical Center David K., Buffalo, NY 14215 | 2020-05-15 |
| Find all providers in BUFFALO | ||||
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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.