DR. ELLEN ROGERS WAGNER (NPI# 1316987753) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316987753 |
| Entity Type | Individual |
| Full Name | DR. ELLEN ROGERS WAGNER |
| Credential | OD |
| Practice Address |
806 Riverside Ave Suite 100 Jacksonville FL 32204-3337 |
| Practice Telephone | 9043567101 |
| Practice Fax Number | 9043567947 |
| Mailing Telephone | 9043567101 |
| Mailing Fax Number | 9043567947 |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2018-01-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 2306 | FL | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | BCBS | 20361 | 01 |
| BCBS | 20361A | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356953467 | Ellen Wagner | Physical Therapist | 10640 N Riverside Dr Ste 200, Fort Worth, TX 76244-9506 | 2020-08-19 |
| 1710508155 | Ellen Wagner | Occupational Therapist | 508 10th Ave, Belmar, NJ 07719-2317 | 2020-04-27 |
| 1871089136 | Ellen Wagner | Pediatrics | 5841 S Maryland Ave # Mc8016, Chicago, IL 60637-1443 | 2018-07-10 |
| 1417349036 | Ellen Wagner | Pharmacist | 5420 Liberty Fairfield Rd, Liberty Twp, OH 45011-2680 | 2015-02-19 |
| 1679975411 | Ellen Africano Wagner | Registered Nurse | 19624 Governors Hwy, Flossmoor, IL 60422-2077 | 2014-09-24 |
| 1821300823 | Ellen Wanda Wagner | Pharmacist | 5006 N Broadway St, Knoxville, TN 37918-2340 | 2010-07-07 |
| 1568408789 | Ellen A Wagner | Nurse Anesthetist, Certified Registered | 265 Herrick Road, Southampton, NY 11968 | 2006-06-22 |
| Street Address |
806 RIVERSIDE AVE SUITE 100 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32204-3337 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487693446 | John Thomas Womack Jr. | Optometrist | 806 Riverside Ave, Suite 100, Jacksonville, FL 32204-3337 | 2006-06-05 |
| 1457712689 | Myeyedr Optometry of Florida, LLC | Optometrist | 806 Riverside Ave, Jacksonville, FL 32204-3300 | 2016-03-16 |
| 1538401476 | William Douglas Smith | Optometrist | 806 Riverside Ave, Jacksonville, FL 32204-3300 | 2013-03-18 |
| 1033349915 | Alison Garlon Webb | Optometrist | 806 Riverside Ave, Jacksonville, FL 32204-3337 | 2009-07-25 |
| 1437170388 | Drs. Wood Lanier and Bowman, Pa | Optometrist | 806 Riverside Ave, Suite 100, Jacksonville, FL 32204-3337 | 2006-07-23 |
| 1255372330 | Wayne Williamson Wood | Optometrist | 806 Riverside Ave, Suite 100, Jacksonville, FL 32204-3337 | 2006-06-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437719853 | North Florida Surgeons, Pa | Orthopaedic Surgery | 2 Shirlciff Ways, Suite 300, Jacksonville, FL 32204 | 2019-06-18 |
| 1770043531 | Manuel Viado Rosas | Physical Therapist | Bold City Therapy and Wellness LLC, 2054 Park Street, Jacksonville, FL 32204 | 2019-03-20 |
| 1255805172 | Tracie Nickole Singh | Marriage & Family Therapist | 1125 W Beaver Street, Suite 205, Jacksonville, FL 32204 | 2019-01-14 |
| 1427548544 | Bold City Therapy and Wellness LLC | Clinic/Center | 2054 Park Street, Jacksonville, FL 32204 | 2018-05-14 |
| 1356883078 | Lcn Enterprise, LLC | Case Manager/Care Coordinator | 1225 W Beaver St Ste 106, Jacksonville, FL 32204 | 2016-11-11 |
| 1073065082 | Prosser and Prosser LLC | Non-emergency Medical Transport (VAN) | 2120 Ernest St, Jacksonville, FL 32204 | 2016-10-26 |
| 1336529817 | Nader Daoud | Internal Medicine | 1 Shircliffway, Jacksonville, FL 32204 | 2015-06-01 |
| 1194119214 | Benjamin James Dionne | Internal Medicine | 2 Shircliff Way Ste 400, Jacksonville, FL 32204 | 2015-03-26 |
| 1598187932 | Jamara Stephens | Counselor | 1225 W Beaver St Ste 205, Jacksonville, FL 32204 | 2014-01-18 |
| 1154743961 | Kathleen Jasper | Nurse Anesthetist, Certified Registered | 2165 Herschel Street, Jacksonville, FL 32204 | 2014-01-14 |
| Find all providers in zip 32204 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215553367 | Myeyedr Optometry of Florida, LLC | Optometrist | 2152 3rd St S # 60, Jacksonville, FL 32250-4019 | 2020-06-24 |
| 1154945814 | Kaitlin Jaquett Brown | Optometrist | 4788 Hodges Blvd Ste 205, Jacksonville, FL 32224-7223 | 2020-05-29 |
| 1831745660 | National Vision Inc | Optometrist | 14021 Lunar Drive, Unit 1, Jacksonville, FL 32218-7290 | 2019-08-16 |
| 1144876475 | Myeyedr Optometry of Florida, LLC | Optometrist | 11945 San Jose Blvd Ste 202, Jacksonville, FL 32223-1612 | 2019-08-13 |
| 1295294742 | Myeyedr Optometry of Florida, LLC | Optometrist | 13760 Old Saint Augustine Rd Ste 102, Jacksonville, FL 32258-5492 | 2019-03-14 |
| 1922578558 | Fatima Hussain Crofton | Optometrist | 7051 Southpoint Parkway S 300, Jacksonville, FL 32216 | 2018-11-27 |
| 1356820211 | Nisha Patel | Optometrist | 10300 Southside Blvd Ste 114, Jacksonville, FL 32256-6759 | 2018-08-11 |
| 1538650155 | Vision Today Pllc | Optometrist | 9365-2 Atlantic Blvd, Jacksonville, FL 32225-8203 | 2018-05-21 |
| 1447765748 | Sudduth Vision Pllc | Optometrist | 8000 Parramore Rd., Jacksonville, FL 32244 | 2017-12-08 |
| 1851806657 | Ann Huynh Nguyen | Optometrist | 9041 Southside Blvd Ste 174, Jacksonville, FL 32256-8482 | 2017-12-04 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32204 |
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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.