JASON E WAGNER (NPI# 1588729768) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588729768 |
| Entity Type | Individual |
| Full Name | JASON E WAGNER |
| Credential | MD |
| Practice Address |
3400 Civic Center Blvd West Pavilion 1st Fl Philadelphia PA 19104-5127 |
| Practice Telephone | 2156623202 |
| Mailing Telephone | 2156623202 |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2019-09-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | MD435611 | PA | Allopathic & Osteopathic Physicians |
| Y | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
MD435611 | PA | Allopathic & Osteopathic Physicians |
| N | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
MD435611 | PA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053700765 | Jason Robert Wagner | Counselor | 8728 S 120 E, Sandy, UT 84070-1526 | 2015-01-19 |
| 1821427287 | Jason Leigh Wagner | Counselor | 505 5th St., Suite 520, Sioux City, IA 51101 | 2013-11-06 |
| 1376003517 | Jason Wagner | Student in an Organized Health Care Education/Training Program | 6431 Fannin St # 1.150, Houston, TX 77030-1501 | 2019-03-22 |
| 1720536691 | Jason Fredrick Wagner | Counselor | 6075 Bathey Ln, Naples, FL 34116-7536 | 2016-09-20 |
| 1215329420 | Jason Wagner | Counselor | 2405 28th St, Anacortes, WA 98221-2484 | 2015-02-25 |
| 1457753519 | Jason Wagner | Physician Assistant | 2025 E Route 66, Glendora, CA 91740-4670 | 2014-09-19 |
| 1902168925 | Jason Kane Wagner | Surgery | 600 N Cattlemen Rd Ste 220, Sarasota, FL 34232-6422 | 2012-06-14 |
| 1093014334 | Jason Wagner | Counselor | 360 Whiskey Hill Rd, Watsonville, CA 95076-8521 | 2011-03-25 |
| 1689641961 | Jason C Wagner | Emergency Medicine | 400 S Kingshighway Blvd, Saint Louis, MO 63110-1014 | 2006-03-05 |
| 1972594471 | Jason Michael Wagner | Radiology | 940 Ne 13th St, Suite 4g4250, Oklahoma City, OK 73104-5008 | 2005-11-03 |
| Street Address |
3400 CIVIC CENTER BLVD WEST PAVILION 1ST FL |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19104-5127 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124027727 | Joel D Glickman | Internal Medicine | 3400 Civic Center Blvd, 1st Floor, Suite 300 S, Philadelphia, PA 19104-4306 | 2005-07-18 |
| 1841891058 | Abigail Brooke Horowitz | Nurse Practitioner | 3400 Civic Center Blvd, Philadelphia, PA 19104-5127 | 2020-11-04 |
| 1073129532 | Samuel Kovell | Physician Assistant | 3400 Civic Center Blvd, Philadelphia, PA 19104-5127 | 2020-09-21 |
| 1306451695 | Farzad Nourollah-zadeh | Oral Medicinist | 3400 Civic Center Blvd, Philadelphia, PA 19104-5127 | 2020-09-13 |
| 1609492917 | Mosetta Harris | Nurse Practitioner | 3400 Civic Center Blvd, Philadelphia, PA 19104-5127 | 2020-06-23 |
| 1063032530 | Monique Maria Tee | Internal Medicine | 3400 Civic Center Blvd, Philadelphia, PA 19104-5127 | 2020-04-24 |
| 1609495290 | Katharine Freeman Michel | Student in an Organized Health Care Education/Training Program | 3400 Civic Center Blvd, 3rd Floor West Pavilion, Philadelphia, PA 19104 | 2020-04-13 |
| 1609495498 | Taha Samir Ghouleh | Student in an Organized Health Care Education/Training Program | 3400 Civic Center Blvd, Philadelphia, PA 19104-5127 | 2020-04-11 |
| 1952930554 | Danielle Marie Lamarra | Nurse Practitioner | 3400 Civic Center Blvd, Philadelphia, PA 19104-5127 | 2020-04-06 |
| 1982232658 | Jasmine Hwang | Student in an Organized Health Care Education/Training Program | 3400 Civic Center Blvd, Philadelphia, PA 19104-5127 | 2020-03-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639770829 | Michelle Morris | Student in an Organized Health Care Education/Training Program | Dept. of Family Medicine & Community Health, 3737 Market, Philadelphia, PA 19104 | 2020-11-04 |
| 1346853041 | Spectrum Health Services, Inc. | Clinic/Center | 1415 South University Ave, Philadelphia, PA 19104 | 2020-08-24 |
| 1770104259 | Fatimah Sorefan-mangou | Student in an Organized Health Care Education/Training Program | 4 Maloney 3400 Spruce Street, Philadelphia, PA 19104 | 2020-05-06 |
| 1114548690 | Rebecca Blaguski | Registered Nurse | The Hospital of The University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104 | 2020-05-06 |
| 1952944175 | Rebecca Miriam Barmherzig | Psychiatry & Neurology | 3501 Civic Centre Blvd, 10th Flr Ctrb, Neurology, Philadelphia, PA 19104 | 2019-10-21 |
| 1891257101 | James Paul Byrne | Surgery | Penn Presbyterian Medical Center, Division of Trauma, S, 51 N. 39th Street, Suite 120, 1st Floor Medical Office, Philadelphia, PA 19104 | 2019-04-04 |
| 1093276453 | Lauren Shreve | Student in an Organized Health Care Education/Training Program | Department of Surgery, Surgery Education - Penn Health, 3400 Spruce Street, 4 Maloney, Philadelphia, PA 19104 | 2019-03-28 |
| 1285194282 | Lauren M Christie | Student in an Organized Health Care Education/Training Program | Penn Presbyterian Medical Center, 51 N. 39th Street, Philadelphia, PA 19104 | 2019-03-25 |
| 1114487683 | Sabrina Layne | Student in an Organized Health Care Education/Training Program | 3400 Spruce Street, 100 Centrex, Philadelphia, PA 19104 | 2019-03-21 |
| 1811457310 | Kia Lor | Student in an Organized Health Care Education/Training Program | Hospital of University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104 | 2019-03-21 |
| Find all providers in zip 19104 | ||||
| Taxonomy Code | 207RC0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Critical Care Medicine |
| An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588180673 | Critical Care Medicine Services LLC | Internal Medicine | 1930 S Broad St Unit 12, Philadelphia, PA 19145-2328 | 2017-08-21 |
| 1811316672 | Christopher Mcgrath | Internal Medicine | 834 Walnut St Ste 605, Philadelphia, PA 19107-5109 | 2014-04-09 |
| 1528323755 | Kartik Ramakrishna | Internal Medicine | 245 N 15th St # Ms 107, Philadelphia, PA 19102-1198 | 2012-07-13 |
| 1639342439 | Nilam Suryakant Mangalmurti | Internal Medicine | 3615 Civic Center Blvd Ste 1015f, Abramson Research Building, Philadelphia, PA 19104-4318 | 2008-04-12 |
| 1457564049 | Methodist Associates In Healthcare, Inc. | Internal Medicine | 2301 South Broad Street, Philadelphia, PA 19148 | 2007-05-08 |
| 1871670943 | Jaber M Monla-hassan | Internal Medicine | 5401 Old York Rd Ste 300, Philadelphia, PA 19141-3045 | 2006-11-01 |
| 1407880578 | Michael W Sims | Internal Medicine | 39th & Market Street, Philadelphia, PA 19104 | 2006-07-11 |
| 1578590089 | Alan Steinbach | Internal Medicine | 3257 Memphis St, Philadelphia, PA 19134-4408 | 2006-06-28 |
| 1962486357 | Mani S Kavuru | Internal Medicine | 834 Walnut St, Suite 650, Philadelphia, PA 19107-5109 | 2005-11-30 |
| 1457356917 | Jeffrey Brian Hoag | Internal Medicine | 219 N Broad St, 9th Floor, Philadelphia, PA 19107-1519 | 2005-06-20 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19104 |
Please comment or provide details below to improve the information on JASON E 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.