SHY L WAGONER (NPI# 1164655452) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164655452 |
| Entity Type | Individual |
| Full Name | SHY L WAGONER |
| Credential | CST |
| Practice Address |
2921 Montvale Dr Springfield IL 62704-5359 |
| Practice Telephone | 2177872700 |
| Practice Fax Number | 2177872715 |
| Mailing Telephone | 2177872700 |
| Mailing Fax Number | 2177872715 |
| Enumeration Date | 2009-09-02 |
| Last Update Date | 2012-02-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 246ZS0410X |
Specialist/Technologist, Other Specialization: Surgical Technologist |
Technologists, Technicians & Other Technical Service Providers |
| Street Address |
2921 MONTVALE DR |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62704-5359 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174502868 | John M Sigle | Podiatrist | 2921 Montvale Dr, Springfield, IL 62704-5359 | 2006-01-11 |
| 1760876999 | Patricia Ann Dennison | Specialist/Technologist, Other | 2921 Montvale Dr, Springfield, IL 62704-5359 | 2015-03-25 |
| 1164856704 | Grant Wilson Gonzalez | Podiatrist | 2921 Montvale Dr, Springfield, IL 62704-5359 | 2013-08-31 |
| 1598058547 | Foot & Ankle Center of Illinois PC | Podiatrist | 2921 Montvale Dr, Springfield, IL 62704-5359 | 2011-05-24 |
| 1841477247 | Springfield Neurosurgical Assocaites, S.c. | Surgery | 2921 Montvale Dr, Springfield, IL 62704-5359 | 2008-01-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902394901 | Hillary Haaker | Occupational Therapist | 2035 W Iles, Suite C, Springfield, ID 62704 | 2018-04-25 |
| 1871095364 | Edward Doyle Slifer Sr. | Pathology | 2117 Greenside Drive, Spring Field, IL 62704 | 2018-03-01 |
| 1598263345 | Santarelli & Feller Dental Group | Dentist | 1140 Rickard Road, Suite B, Springfield, IL 62704 | 2018-01-26 |
| 1447774757 | Lisa Ann Rogers | Developmental Therapist | 2101 Lexington Dr, Apt 3, Springfield, IL 62704 | 2017-07-28 |
| 1730611286 | Mindi Rowe | Occupational Therapist | 2508 County Rd 4 1/2 E, Springfield, IL 62704 | 2017-04-03 |
| 1366992208 | Jayme Jordan | Contractor | 2409 Westchester Blvd, Springfield, IL 62704 | 2016-10-04 |
| 1154793974 | Dina Payne | Social Worker | 917 Clocktower Drive, Suite 600, Springfield, IL 62704 | 2015-10-21 |
| 1770959819 | James R Reynolds | Hearing Instrument Specialist | 2347 W Monroe St, Springfield, IL 62704 | 2015-08-12 |
| 1336576495 | Emily Jane Dungey | Counselor | 920 S Spring St Ste 1300, Springfield, IL 62704 | 2013-10-03 |
| 1942552161 | Jeannie Marie Hundley | Specialist/Technologist, Other | 2921 Monvale Drive, Springfield, IL 62704 | 2012-10-11 |
| Find all providers in zip 62704 | ||||
| Taxonomy Code | 246ZS0410X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Specialist/Technologist, Other |
| Specialization | Surgical Technologist |
| Surgical technologists are allied health professionals, who are an integral part of the team of medical practitioners providing surgical care to patients. Surgical technologists work under the supervision of a surgeon to facilitate the safe and effective conduct of invasive surgical procedures, ensuring that the operating room environment is safe, that equipment functions properly, and that the operative procedure is conducted under conditions that maximize patient safety. Surgical technologists possess expertise in the theory and application of sterile and aseptic technique and combine the knowledge of human anatomy, surgical procedures, and implementation tools and technologies to facilitate a physician's performance of invasive therapeutic and diagnostic procedures. |
| Notes: Source: Association of Surgical Technologists, "Job Description: Surgical Technologist," 2014. [7/1/2014: code modified, title modified, definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225184401 | Melissa Kay Watson | Specialist/Technologist, Other | 320 E Carpenter St Ste 1a, Springfield, IL 62702-5165 | 2007-01-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073075420 | Deborah Kay Schroh | Specialist/Technologist, Other | 2350 Ravine Way Ste 400, Glenview, IL 60025-7621 | 2019-04-04 |
| 1447750708 | Shelley R. Ruch | Specialist/Technologist, Other | 1604 Visa Drive, Ste 1, Normal, IL 61761 | 2018-02-13 |
| 1427508076 | Mitchell Bogda | Specialist/Technologist, Other | 132 Bertram Dr Unit K, Yorkville, IL 60560-3212 | 2016-10-06 |
| 1972960193 | Kayla Rushing | Specialist/Technologist, Other | 101 S Birkey St, Goodfield, IL 61742-9631 | 2016-01-19 |
| 1174953186 | Christine Smith | Specialist/Technologist, Other | 12701 W 143rd St Ste 200, Homer Glen, IL 60491-7723 | 2013-11-13 |
| 1114356557 | Vladimir Stalev | Specialist/Technologist, Other | 5978 N Lincoln Ave Apt 2c, Chicago, IL 60659-3747 | 2013-11-06 |
| 1760811665 | Allan Cortes | Specialist/Technologist, Other | 807 Ann St, Joliet, IL 60435-0400 | 2013-11-01 |
| 1972942258 | Viktor Tabatchyk | Specialist/Technologist, Other | 109 Frank Lloyd Wright Ln, Oak Park, IL 60302-2644 | 2013-06-19 |
| 1316280514 | Lyubov Andrushkiv | Specialist/Technologist, Other | 840 N Oakley Blvd Apt 2, Chicago, IL 60622-4735 | 2013-04-05 |
| 1104166875 | Amit Riman | Specialist/Technologist, Other | 1851 President St, Glendale Heights, IL 60139-1978 | 2013-02-18 |
| Find all providers with the same taxonomy | ||||
| City | SPRINGFIELD |
| Zip Code | 62704 |
Please comment or provide details below to improve the information on SHY L WAGONER.
| 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.