DR. ANDREW WAGNER (NPI# 1215317888) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215317888 |
| Entity Type | Individual |
| Full Name | DR. ANDREW WAGNER |
| Practice Address |
510 S Kingshighway Blvd Saint Louis MO 63110-1016 |
| Practice Telephone | 8557233723 |
| Mailing Telephone | 8557233723 |
| Enumeration Date | 2015-06-08 |
| Last Update Date | 2020-07-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
266705 | MA | Allopathic & Osteopathic Physicians |
| Y | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
2020015515 | MO | Allopathic & Osteopathic Physicians |
| N | 208600000X | Surgery | 125067171 | IL | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780198416 | Andrew Howard Wagner | Physical Therapist | 120 Briggswood Dr, Elma, NY 14059-9477 | 2017-11-16 |
| 1568860401 | Andrew Anthony Wagner | Chiropractor | 103 N Choteau Ave, Hardin, MT 59034-2111 | 2014-12-09 |
| 1992072151 | Andrew Wagner | Pharmacist | 4295 County Road 12, Lafayette, AL 36862-5209 | 2011-11-16 |
| 1427130814 | Andrew Thomas Wagner | Physical Therapist | 10205 Hickory Valley Dr, Fort Wayne, IN 46835-9558 | 2006-10-19 |
| 1285722819 | Andrew Stephen Wagner | Family Medicine | 819 Longwood Ln, Sebastopol, CA 95472-2734 | 2006-10-10 |
| 1699722082 | Andrew A Wagner | Urology | Rabb 440, Beth Israel Deaconess Medical Center, Boston, MA 02215-0000 | 2006-05-30 |
| 1306802087 | Andrew Blake Wagner | Physical Therapist | 7701 West Kilgore, Ste 1a, Yorktown, IN 47396 | 2006-04-22 |
| 1619511623 | Andrew Wagner | Pharmacist | 302 Valley Hi Dr, San Antonio, TX 78227-4602 | 2019-11-01 |
| 1861058315 | Andrew John Wagner | Audiologist | 3170 N Federal Hwy Ste 115, Lighthouse Point, FL 33064-6786 | 2019-05-09 |
| 1861978819 | Andrew Wagner | Nurse Anesthetist, Certified Registered | 2823 Fresno St, Fresno, CA 93721-1324 | 2018-07-12 |
| Street Address |
510 S KINGSHIGHWAY BLVD |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63110-1016 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033107982 | Laurie L Fajardo | Radiology | 510 S Kingshighway Blvd, Saint Louis, MO 63110-1016 | 2005-10-13 |
| 1902442650 | Amir Iravani Tabrizipour | Nuclear Medicine | 510 S Kingshighway Blvd, Saint Louis, MO 63110-1016 | 2019-11-18 |
| 1942850078 | Paul-robert Derenoncourt | Nuclear Medicine | 510 S Kingshighway Blvd, Saint Louis, MO 63110-1016 | 2019-09-20 |
| 1659861615 | Alexander Baireddy Reddy | Radiology | 510 S Kingshighway Blvd, Saint Louis, MO 63110 | 2018-05-15 |
| 1508356700 | Daniel Crawford | Student in an Organized Health Care Education/Training Program | 510 S Kingshighway Blvd, Saint Louis, MO 63110-1016 | 2018-05-14 |
| 1154826675 | Eric Weiner | Student in an Organized Health Care Education/Training Program | 510 S Kingshighway Blvd, Saint Louis, MO 63110-1016 | 2018-03-27 |
| 1447754767 | Allison L Schell | Physician Assistant | 510 S Kingshighway Blvd, Saint Louis, MO 63110-1016 | 2018-03-21 |
| 1407381262 | Philip Andrew Velez | Student in an Organized Health Care Education/Training Program | 510 S Kingshighway Blvd, Saint Louis, MO 63110-1016 | 2017-04-28 |
| 1154778959 | Jimmy Xu | Radiology | 510 S Kingshighway Blvd, Saint Louis, MO 63110-1016 | 2016-05-21 |
| 1124402573 | Wei Wang | Radiology | 510 S Kingshighway Blvd, Dept Radiology, Saint Louis, MO 63110-1016 | 2015-07-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659971992 | Carrie Ellen Smith | Nurse Practitioner | Mailstop 90-00-174, One Barnes-jewish Plaza, St. Louis, MO 63110 | 2020-10-27 |
| 1881210466 | Michelle Amanda Freilich | Internal Medicine | Barnes-jewish Plaza, St. Louis, MO 63110 | 2020-06-19 |
| 1245856046 | Jeevin Shahi | Radiology | 3685 Vista Avenue, Center for Radiation Medicine, St. Louis, MO 63110 | 2020-06-18 |
| 1497371314 | Wilson Eduardo Rodriguez | Student in an Organized Health Care Education/Training Program | 1008 S. Spring, St Louis, MO 63110 | 2020-06-17 |
| 1578184065 | Kathryn Kay Lindsay | Registered Nurse | Saint Louis University Dept of Surgery, 3635 Vista Ave 3dt, St Louis, MO 63110 | 2020-05-06 |
| 1881232700 | Ashley Diane Pace | Nurse Practitioner | 1 Parkview Place, Shoenberg 6900, St. Louis, MO 63110 | 2019-12-11 |
| 1619520418 | Krithika Damodar Shenoy | Pathology | 660 Euclid Avenue, One Barnes Jewish Hospital Plaza, St. Louis, MO 63110 | 2019-07-20 |
| 1467912550 | Ian Ferguson | Dermatology | 660 S Euclid Ave., Cb 8123, St. Louis, MO 63110 | 2019-03-23 |
| 1760978688 | Ihab Hassanieh | Student in an Organized Health Care Education/Training Program | 33660 Vista Ave, St. Louis, MO 63110 | 2018-07-03 |
| 1336634500 | Martin K Mwangi | Pediatrics | 1 Childrens Place, 3s34, St. Louis, M, MO 63110 | 2018-06-28 |
| Find all providers in zip 63110 | ||||
| Taxonomy Code | 2085R0204X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Vascular & Interventional Radiology |
| A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649396334 | William Edward Holloway | Radiology | 226 N Boyle Ave Apt 2n, Saint Louis, MO 63108-2922 | 2007-03-22 |
| 1851895718 | Allison Khoo | Radiology | 1 Barnes Jewish Hospital Plz, Saint Louis, MO 63110 | 2018-03-23 |
| 1922530666 | Francisco Javier Gortes | Radiology | 1 Barnes Jew Hosp Plz, Saint Louis, MO 63110 | 2017-03-31 |
| 1154778959 | Jimmy Xu | Radiology | 510 S Kingshighway Blvd, Saint Louis, MO 63110-1016 | 2016-05-21 |
| 1396152005 | Ahmed Abdelbaki | Radiology | 3635 Vista Ave, Saint Louis, MO 63110-2539 | 2014-07-14 |
| 1124446844 | Alexander Ushinsky | Radiology | 510 S Kingshighway Blvd, Saint Louis, MO 63110 | 2014-03-31 |
| 1225391592 | Ali Malik | Radiology | 3635 Vista Ave, Saint Louis, MO 63110-2539 | 2012-06-20 |
| 1306131974 | Jerome Kao | Radiology | 3635 Vista Ave, Department of Radiology, Saint Louis, MO 63110 | 2011-06-12 |
| 1346553443 | Louis Maurice Morel-ovalle | Radiology | 3635 Vista Ave, Ssm Health Dept of Radiology, Saint Louis, MO 63110-2539 | 2010-07-17 |
| 1609192277 | Pavan K Kavali | Radiology | 510 S Kingshighway Blvd, Saint Louis, MO 63110-1016 | 2010-04-07 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63110 |
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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.