DONALD C WAGNER (NPI# 1811065675) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811065675 |
| Entity Type | Individual |
| Full Name | DONALD C WAGNER |
| Credential | M.D. |
| Practice Address |
1350 S Hickory Street Melbourne FL 32901 |
| Mailing Address |
Po Box 361907 Melbourne FL 32906-1907 |
| Practice Telephone | 3212546218 |
| Practice Fax Number | 3212546230 |
| Mailing Telephone | 3212546218 |
| Mailing Fax Number | 3212546320 |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2012-02-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | ME0043255 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 068252700 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295838878 | Donald Edward Wagner | Dentist | 147 Willow Ridge Dr, Amherst, NY 14228-3050 | 2006-09-07 |
| 1376540989 | Donald Wagner | Chiropractor | 10 Copperfield Cir, Lititz, PA 17543-9481 | 2005-06-29 |
| 1134248867 | Donald J Wagner | Emergency Medicine | 1355 Ramar Rd, Ste 11, Bullhead City, AZ 86442-7100 | 2007-03-27 |
| Street Address |
1350 S HICKORY STREET |
| City | MELBOURNE |
| State | FL |
| Zip Code | 32901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912901455 | Robert D. Karch | Pediatrics | 1350 S Hickory Street, Holmes Regional Medical Center, Melbourne, FL 32901 | 2005-06-13 |
| 1104013226 | Aaron Lee Stclair | Emergency Medicine | 1350 S Hickory Street, Melbourne, FL 32901 | 2007-10-02 |
| 1336227552 | Christopher S Rehak | Emergency Medicine | 1350 S Hickory Street, Melbourne, FL 32901 | 2006-11-02 |
| 1407937733 | James Timothy Miles | Emergency Medicine | 1350 S Hickory Street, Melbourne, FL 32901 | 2006-10-17 |
| 1992807150 | Clarence James Bronstema | Emergency Medicine | 1350 S Hickory Street, Melbourne, FL 32901 | 2006-09-01 |
| 1891800728 | Philip B Hopkins | Emergency Medicine | 1350 S Hickory Street, Melbourne, FL 32901 | 2006-08-20 |
| 1457466385 | Milan Jockovich | Emergency Medicine | 1350 S Hickory Street, Melbourne, FL 32901 | 2006-08-20 |
| 1093725996 | John P Griffin | Emergency Medicine | 1350 S Hickory Street, Melbourne, FL 32901 | 2006-08-09 |
| 1295745107 | Rajesh Gutta | Emergency Medicine | 1350 S Hickory Street, Melbourne, FL 32901 | 2006-08-09 |
| 1295753218 | Ronald T Gilroy | Emergency Medicine | 1350 S Hickory Street, Melbourne, FL 32901 | 2006-07-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467062943 | George Pappas | Anesthesiologist Assistant | 1775 W. Hibiscus Blvd., Ste 215, Melbourne, FL 32901 | 2020-08-09 |
| 1124676820 | Abbi Dell Lee | Behavioral Analyst | 3251 Engineering St, Melbourne, FL 32901 | 2019-08-27 |
| 1750856878 | Jeffrey Michael Cavanagh | Behavior Technician | 3251 Engineering Street, Melbourne, FL 32901 | 2018-10-04 |
| 1740766021 | Amanda Miller | Behavior Technician | 1885 W Hibiscus Blvd, Melbourne, FL 32901 | 2018-07-19 |
| 1396244406 | Dragen II LLC | Urology | 129 W Hibiscus Blvd Ste D, Melbourne, FL 32901 | 2018-02-03 |
| 1225550692 | Cabrit Psychotherapy Services LLC | Marriage & Family Therapist | 100 Rialto Place, Suite 700, Melbourne, FL 32901 | 2017-07-07 |
| 1487188058 | Project Response, Inc. | Clinic/Center | 747 S. Apollo Boulevard, Melbourne, FL 32901 | 2017-04-20 |
| 1184174575 | Paulette Swanson | Physical Therapist | 611 East Sheridan Rd, Melbourne, FL 32901 | 2016-10-10 |
| 1841747839 | Nicholas Wilson | Social Worker | 3661 S. Babcock St., Melbourne, FL 32901 | 2016-09-07 |
| 1467804278 | Nickolas Hetherington | Occupational Therapist | 1900 S Harbor City Blvd Ste 108, Melbourne, FL 32901 | 2016-07-05 |
| Find all providers in zip 32901 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578857207 | Michael John Homerick | Emergency Medicine | 4230 Stoney Point Rd, Melbourne, FL 32940-1476 | 2011-05-28 |
| 1871704247 | David Scott Gettings | Emergency Medicine | 991 Thomas Barbour Dr, Melbourne, FL 32935-6966 | 2007-05-25 |
| 1558434217 | Robert Joseph Benkendorf | Emergency Medicine | 993 Fostoria Dr, Melbourne, FL 32940-1513 | 2006-11-17 |
| 1437260791 | John R Mcpherson | Emergency Medicine | 1350 S. Hickory Street, Melbourne, FL 32901 | 2006-08-31 |
| 1306848668 | Robert Bell | Emergency Medicine | 250 N Wickham Rd, Melbourne, FL 32935-8625 | 2005-06-01 |
| 1013321280 | Corey Alvarez | Emergency Medicine | 1775 W Hibiscus Blvd Ste 215, Melbourne, FL 32901-2627 | 2014-06-16 |
| 1154744068 | Kali Rae D'onofrio | Emergency Medicine | 1350 Hickory St, Melbourne, FL 32901-3224 | 2014-01-28 |
| 1346686573 | Kevin Robert Norris Freels | Emergency Medicine | 250 N Wickham Rd, Melbourne, FL 32935-8625 | 2013-05-15 |
| 1750665477 | Brevard Hyperbarics LLC | Emergency Medicine | 1350 Hickory St, Melbourne, FL 32901-3224 | 2011-09-29 |
| 1487940060 | Robert C Ford IIi | Emergency Medicine | 1350 Hickory St, Melbourne, FL 32901-3224 | 2011-06-22 |
| Find all providers in MELBOURNE | ||||
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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.