VICTOR S WAGNER (NPI# 1457383820) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457383820 |
| Entity Type | Individual |
| Full Name | VICTOR S WAGNER |
| Credential | PHD |
| Practice Address |
Mecosta County Medical Center 605 Oak Street Big Rapids MI 49307 |
| Mailing Address |
858 Pinecrest Ave Se Grand Rapids MI 49506-3435 |
| Practice Telephone | 2315924444 |
| Mailing Telephone | 6167196208 |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2008-03-07 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
6301008134 | MI | Behavioral Health & Social Service Providers |
| Street Address |
MECOSTA COUNTY MEDICAL CENTER 605 OAK STREET |
| City | BIG RAPIDS |
| State | MI |
| Zip Code | 49307 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467099150 | Jayne Ann Graham | Custodial Care Facility | 831 Rose Avenue, Big Rapids, MI 49307 | 2019-12-02 |
| 1457904369 | Shannon Lynn Barstow | Registered Nurse | 20661 Okemos Rd, Big Rapids, MI 49307 | 2019-07-19 |
| 1235637604 | Kendra Lee Dolorfino | Nurse Practitioner | 650 Linden St Ste 4, Big Rapids, MI 49307 | 2018-01-31 |
| 1326553959 | Hope Primary and Urgent Care of Big Rapids Pllc | Clinic/Center | 201 Linden Street, Big Rapids, MI 49307 | 2017-12-05 |
| 1740539824 | Brandee Lee Gard | Community Health Worker | 745 Water Tower Rd., Big Rapids, MI 49307 | 2012-09-05 |
| 1497071641 | Kathleen Johnson | Adult Companion | 208 Maple St., Apt. 208, Big Rapids, MI 49307 | 2010-04-13 |
| 1144466822 | Big Rapids Dental Health Care Associates, PC | Dentist | 201 S. Michigan Ave, Big Rapids, MI 49307 | 2008-12-30 |
| 1134379894 | Fred Rodriguez | Hearing Instrument Specialist | 13452 Northland Drive, Big Rapids, MI 49307 | 2008-09-30 |
| 1740447275 | Catholic Charities West Michig | Community/Behavioral Health | 212 1/2 Maple Street, Big Rapids, MI 49307 | 2008-05-21 |
| 1144353905 | Robert R Scharp Dds PC | Dentist | 126 Maple St, Big Rapids, MI 49307 | 2007-03-13 |
| Find all providers in zip 49307 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881738276 | Susan H Fowler | Psychologist | 18554 Northland Dr, Big Rapids, MI 49307-8788 | 2007-02-18 |
| 1962575274 | Donald Leo Totten | Psychologist | 211 Maple, Totten Psychological Services, Big Rapids, MI 49307 | 2006-11-16 |
| 1336209444 | Eileen L. Heuvelhorst | Psychologist | 500 S 3rd Ave, Big Rapids, MI 49307-9501 | 2006-12-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245831296 | Reema S. Beri, Phd, LLC | Psychologist | 49410 Waterstone Estates Cir, Northville, MI 48168-4900 | 2020-11-05 |
| 1952901225 | Northerner Psychological Services, Pllc | Psychologist | 1869 Melbourne St, Birmingham, MI 48009-1160 | 2020-10-27 |
| 1083213631 | Robert J. Sheppard Phd Pllc | Psychologist | 8339 Brookwood Dr, Portage, MI 49024-5207 | 2020-10-23 |
| 1952900037 | Jamila Simone Steward | Psychologist | 31275 Northwestern Hwy Ste 216, Farmington Hills, MI 48334-2570 | 2020-10-20 |
| 1992303465 | Madison Bryant | Psychologist | 1231 S Cass Lake Rd, Waterford, MI 48328-4739 | 2020-10-15 |
| 1730787664 | Athal Yako | Psychologist | 18230 Teresa Dr, Macomb, MI 48044-1681 | 2020-10-13 |
| 1538767678 | Up Telehealth, LLC | Psychologist | 228 W Washington St Ste 7, Marquette, MI 49855-4330 | 2020-10-12 |
| 1881292076 | Meaningful Change: Clinical & Consultation Psychology, Pllc | Psychologist | 1861 Woodland Dr, Mount Pleasant, MI 48858-1298 | 2020-10-11 |
| 1902404122 | Dorrean Riley | Psychologist | 19189 Lexington, Redford, MI 48240-2618 | 2020-10-09 |
| 1174130850 | Timber Creek Counseling West LLC | Psychologist | 2976 Ivanrest Ave Sw Ste 215, Grandville, MI 49418-1440 | 2020-09-28 |
| Find all providers with the same taxonomy | ||||
| City | BIG RAPIDS |
| Zip Code | 49307 |
Please comment or provide details below to improve the information on VICTOR S WAGNER.
| 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.