NICOLE ANN WAGAMAN (NPI# 1689011405) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689011405 |
| Entity Type | Individual |
| Full Name | NICOLE ANN WAGAMAN |
| Credential | D.O. |
| Practice Address |
2801 Heartland Dr. Coralville IA 52241 |
| Mailing Address |
1776 Woodstead Ct Ste 208 The Woodlands TX 77380-1480 |
| Practice Telephone | 8777497428 |
| Practice Fax Number | 5126283314 |
| Mailing Telephone | 8777497428 |
| Mailing Fax Number | 5126283314 |
| Enumeration Date | 2013-06-03 |
| Last Update Date | 2020-04-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | R-9752 | IA | Allopathic & Osteopathic Physicians |
| Y | 2081P0004X |
Physical Medicine & Rehabilitation Specialization: Spinal Cord Injury Medicine |
DO-05546 | IA | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1801 Hickman Rd, Des Moines, IA 503141505 | 5152825640 | 5152822332 |
| Street Address |
2801 HEARTLAND DR. |
| City | CORALVILLE |
| State | IA |
| Zip Code | 52241 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780281915 | Impact Physician Group Iowa LLC | Internal Medicine | 2801 Heartland Dr, Coralville, IA 52241 | 2020-10-01 |
| 1114550886 | Encompass Health Rehabilitation Hospital of Iowa City, LLC | Rehabilitation Hospital | 2450 Coral Court, Coralville, IA 52241 | 2020-02-20 |
| 1215575394 | Eastern Iowa Rehabilitation Hospital, LLC | Rehabilitation Hospital | 2801 Heartland Drive, Coralville, IA 52241 | 2019-12-19 |
| 1851938690 | Matthew Easley | Speech-Language Pathologist | 2854 Coral Court, Ste 1, On With Life Outpatient Neuro Rehabilitation, Coralville, IA 52241 | 2019-11-27 |
| 1245892629 | On With Life, Inc | Clinic/Center | 2854 Coral Court, Suite 1, Coralville, IA 52241 | 2019-07-05 |
| 1376024869 | Hy Vee Inc | Pharmacy | 3285 Crosspark Road, Coralville, IA 52241 | 2018-08-23 |
| 1861996191 | Roggy Vision Center, Pllc | Optometrist | 708 5th St Ste 1, Coralville, IA 52241 | 2018-03-21 |
| 1013446467 | Monica Basile | Midwife | 501 12th Ave, St 102, Coralville, IA 52241 | 2017-06-08 |
| 1568893121 | Mohamed Karim | Chiropractor | 1801 Brown Deer Trail, Coralville, IA 52241 | 2013-12-09 |
| 1811246473 | State University of Iowa | Pharmacy | 105 E 9th Street, Suite A, Coralville, IA 52241 | 2012-08-29 |
| Find all providers in zip 52241 | ||||
| Taxonomy Code | 2081P0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Specialization | Spinal Cord Injury Medicine |
| A physician who addresses the prevention, diagnosis, treatment and management of traumatic spinal cord injury and non-traumatic etiologies of spinal cord dysfunction by working in an interdisciplinary manner. Care is provided to patients of all ages on a lifelong basis and covers related medical, physical, psychological and vocational disabilities and complications. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Physical Medicine and Rehabilitation, 2007. http://www.abpmr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Physical Medicine and Rehabilitation. ACGME Accredited Residency Program Requirements: 1 year of training with 3-5 years in relevant specialty for a total of 4-6 years. ABMS Approved Subspecialty Certificate: (Physical Medicine and Rehabilitation) |
| City | CORALVILLE |
| Zip Code | 52241 |
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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.