DR. PETER J WAGNER (NPI# 1285995100) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285995100 |
| Entity Type | Individual |
| Full Name | DR. PETER J WAGNER |
| Credential | M.D. |
| Practice Address |
2 Dudley St Ste 200 Providence RI 02905 |
| Mailing Address |
Po Box 1119 Providence RI 02901-1119 |
| Practice Telephone | 4013301476 |
| Mailing Telephone | 4014434150 |
| Enumeration Date | 2012-06-07 |
| Last Update Date | 2018-06-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | MD16294 | RI | Allopathic & Osteopathic Physicians |
| N | 207X00000X | Orthopaedic Surgery | 253099 | MA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235676008 | Peter Louis Wagner | Dentist | 1292 S Market Blvd, Chehalis, WA 98532-3645 | 2017-01-31 |
| 1245440841 | Peter Wagner | Internal Medicine | 350 Heritage Way, Suite 1100, Kalispell, MT 59901-3158 | 2007-05-23 |
| 1609992932 | Peter C. Wagner | Dentist | 1292 S Market Blvd, Chehalis, WA 98532-3645 | 2007-03-21 |
| 1548356280 | Peter Louis Wagner | Dentist | 10535 N Port Washington Rd, Suite 102, Mequon, WI 53092-5583 | 2006-10-04 |
| 1174531388 | Peter William Wagner | Surgery | 30 W Mccreight Ave, Suite 208, Springfield, OH 45504-1842 | 2006-08-03 |
| 1598734196 | Peter B Wagner | Internal Medicine | 600 Moye Blvd, Greenville, NC 27834-4300 | 2006-03-16 |
| 1659341865 | Peter C Wagner | Family Medicine | 483 W. Seed Farm Rd., Sacaton, AZ 85147-0038 | 2006-01-23 |
| 1396729539 | Peter J Wagner | Internal Medicine | 1221 Whipple St, Eau Claire, WI 54703-5270 | 2005-12-01 |
| 1962403774 | Peter John Wagner | Psychiatry & Neurology | 39700 Bob Hope Dr, Suite 216, Rancho Mirage, CA 92270-3267 | 2005-08-02 |
| Street Address |
2 DUDLEY ST STE 200 |
| City | PROVIDENCE |
| State | RI |
| Zip Code | 02905 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770674996 | Joseph Anthony Izzi Jr. | Orthopaedic Surgery | 2 Dudley St Ste 200, Providence, RI 02905 | 2006-09-27 |
| 1538776521 | Susan Carter | Physical Therapist | 2 Dudley St Ste 200, Providence, RI 02905-3248 | 2020-09-24 |
| 1235580192 | Erin Haggerty | Orthopaedic Surgery | 2 Dudley St Ste 200, Providence, RI 02905-3248 | 2016-06-22 |
| 1487038303 | Matthew Jones | Orthopaedic Surgery | 2 Dudley St Ste 200, Providence, RI 02905-3248 | 2015-07-10 |
| 1326429408 | Shyam Patel | Orthopaedic Surgery | 2 Dudley St Ste 200, Providence, RI 02905-3248 | 2015-06-15 |
| 1194106716 | Neill Li | Orthopaedic Surgery | 2 Dudley St Ste 200, Providence, RI 02905-3248 | 2015-06-10 |
| 1861870321 | Michael Mariorenzi | Orthopaedic Surgery | 2 Dudley St Ste 200, Providence, RI 02905-3248 | 2015-05-15 |
| 1033597687 | Gregory Elia | Orthopaedic Surgery | 2 Dudley St Ste 200, Providence, RI 02905-3248 | 2015-05-15 |
| 1326426925 | Andrew P. Thome Jr. | Orthopaedic Surgery | 2 Dudley St Ste 200, Providence, RI 02905-3248 | 2015-05-14 |
| 1821476607 | Steven Bokshan | Orthopaedic Surgery | 2 Dudley St Ste 200, Providence, RI 02905-3248 | 2015-05-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477100808 | Raisa Emilia Garcia-diaz | Counselor | 66 Pavilion Avenue, Providence, RI 02905 | 2019-08-21 |
| 1962976571 | Nike A. Kendall | Social Worker | Program In Women's Oncology, 101 Dudley Street, Providence, RI 02905 | 2019-01-16 |
| 1891265443 | Carolyn Te Young | Pathology | 1320 Narragansett Blvd, Cranston, RI 02905 | 2018-11-27 |
| 1417427071 | Julianne Elizabeth Houtchens | Dietitian, Registered | Adult Primary Care 245 Chapman Street, Providence, RI 02905 | 2018-11-27 |
| 1922577394 | Dilenia C Cruz | Health Educator | 335r Prairie Ave., Suite 2b, Providence, RI 02905 | 2018-11-15 |
| 1639653116 | Varina S. Gunn | Health Educator | 335r Prarie Ave., Suite 2b, Providence, RI 02905 | 2018-09-20 |
| 1427590421 | Cardea Healthcare LLC | In Home Supportive Care | 100 Pavilion Avenue, Suite 101, Providence, RI 02905 | 2016-11-08 |
| 1265884597 | Maxwell King | Physical Therapy Assistant | 48 Moorland Avenue, Cranston, RI 02905 | 2016-07-11 |
| 1346698024 | Samantha Lea Colli | Physician Assistant | 100 Dudley St Fl 3, Providence, RI 02905 | 2016-06-02 |
| 1346697448 | Amy Jean Simpson | Marriage & Family Therapist | 1981 Broad Street, Cranston, RI 02905 | 2016-05-18 |
| Find all providers in zip 02905 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851556849 | Stephan D Deutsch | Orthopaedic Surgery | 1 Wayland Ave Unit 316n, Providence, RI 02906-4565 | 2008-07-19 |
| 1568420115 | Peter A Pizzarello | Orthopaedic Surgery | 868 Admiral St, Providence, RI 02904 | 2006-05-03 |
| 1033103098 | Stanley John Stutz Jr. | Orthopaedic Surgery | 21 Peace St, Corporate Care, Providence, RI 02907-1510 | 2005-09-07 |
| 1447254479 | Thomas Francis Bliss Jr. | Orthopaedic Surgery | 100 Butler Dr, Providence, RI 02906-4862 | 2005-06-08 |
| 1548883457 | Myles Dworkin | Orthopaedic Surgery | 593 Eddy St, Providence, RI 02903-4923 | 2020-05-27 |
| 1023631181 | Lauren Elizabeth Piana | Orthopaedic Surgery | 593 Eddy St, Providence, RI 02903-4923 | 2020-05-24 |
| 1992328025 | Patrick J Morrissey | Orthopaedic Surgery | 593 Eddy St, Providence, RI 02903-4923 | 2020-05-23 |
| 1164045712 | Eleanor Sydney Burstein | Orthopaedic Surgery | 593 Eddy St, Providence, RI 02903-4923 | 2020-05-18 |
| 1265054100 | Joseph Christopher Cusano | Orthopaedic Surgery | 593 Eddy St, Providence, RI 02903-4923 | 2020-05-14 |
| 1265054159 | Matthew Quinn | Orthopaedic Surgery | 593 Eddy St, Providence, RI 02903-4923 | 2020-05-13 |
| Find all providers in PROVIDENCE | ||||
| City | PROVIDENCE |
| Zip Code | 02905 |
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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.