DR. JEFFREY DAVID WAGNER (NPI# 1881690790) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881690790 |
| Entity Type | Individual |
| Full Name | DR. JEFFREY DAVID WAGNER |
| Credential | MD |
| Practice Address |
8040 Clearvista Pkwy Ste 570 Indianapolis IN 46256 |
| Mailing Address |
8040 Clearvista Pkwy Ste 570 Indianapolis IN 46256-4673 |
| Practice Telephone | 3176212520 |
| Practice Fax Number | 3176212580 |
| Mailing Telephone | 3176212520 |
| Mailing Fax Number | 3176212580 |
| Enumeration Date | 2005-06-24 |
| Last Update Date | 2018-09-14 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
01041504 | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 100347810 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881151876 | Jeffrey Frank Wagner | Pharmacist | 6310 Health Park Way Ste 130, Lakewood Ranch, FL 34202-5177 | 2019-02-26 |
| 1760521843 | Jeffrey M Wagner | Psychologist | 500 Market Street 1-g, Portsmouth, NH 03801 | 2007-02-06 |
| 1437244050 | Jeffrey Todd Wagner | Physical Therapist | 1 Gateway Drive, Wading River, NY 11792 | 2006-10-03 |
| 1891744967 | Jeffrey Douglas Wagner | Physician Assistant | 18 Ronald Ln, Sayville, NY 11782-1622 | 2006-05-08 |
| 1881684207 | Jeffrey M Wagner | Allergy & Immunology | 98 Willow Ln, Spartanburg, SC 29307-1357 | 2005-10-26 |
| 1255894481 | Jeffrey Ryan Wagner | Student in an Organized Health Care Education/Training Program | 2425 Geary Blvd, San Francisco, CA 94115-3358 | 2019-04-14 |
| 1003312117 | Jeffrey Wagner | Clinical Exercise Physiologist | 3525 E Louise Dr, Meridian, ID 83642-6302 | 2018-04-05 |
| 1023552114 | Jeffrey David Wagner | Nurse Practitioner | 3303 Sw Bond Ave, Portland, OR 97239 | 2016-12-08 |
| 1578798914 | Jeffrey Mark Wagner | Physical Therapist | 1430 Esplanade, Suite 8, Chico, CA 95926-3366 | 2009-05-28 |
| 1568624187 | Jeffrey G Wagner | Family Medicine | 9280 W Sunset Rd Ste 200, Las Vegas, NV 89148 | 2008-06-25 |
| Street Address |
8040 CLEARVISTA PKWY STE 570 |
| City | INDIANAPOLIS |
| State | IN |
| Zip Code | 46256 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295185288 | Grant E Highley | Anesthesiology | 8040 Clearvista Pkwy, Indianapolis, IN 46256-5630 | 2016-06-21 |
| 1376993030 | Megan Savka | Nurse Practitioner | 8040 Clearvista Pkwy, Ste 240, Indianapolis, IN 46256-5630 | 2016-06-14 |
| 1609226414 | Andrew C Pauszek | Anesthesiology | 8040 Clearvista Pkwy, Indianapolis, IN 46256-5630 | 2016-06-13 |
| 1235592007 | Michelle P Arce | Anesthesiology | 8040 Clearvista Pkwy, Indianapolis, IN 46256-5630 | 2016-03-30 |
| 1215307178 | Bonnie Howard | Community Health Worker | 8040 Clearvista Pkwy, Ste 440, Indianapolis, IN 46256-5630 | 2015-10-04 |
| 1730564014 | Community Physicians of Indiana Inc | Orthopaedic Surgery | 8040 Clearvista Pkwy, Suite 440, Indianapolis, IN 46256-4673 | 2015-07-28 |
| 1780064295 | Jordon Lachowecki | Anesthesiology | 8040 Clearvista Pkwy, Indianapolis, IN 46256-5630 | 2015-06-01 |
| 1518352566 | Ben Shelley | Anesthesiology | 8040 Clearvista Pkwy, Indianapolis, IN 46256-5630 | 2015-04-06 |
| 1902290133 | Laura Palmer | Anesthesiology | 8040 Clearvista Pkwy, Indianapolis, IN 46256-5630 | 2015-03-25 |
| 1124412408 | Alex J Susott | Anesthesiology | 8040 Clearvista Pkwy, Indianapolis, IN 46256-5630 | 2015-03-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790316859 | Jacob R Weeks | Behavior Technician | 9769 Crosspointed Blvd, Fishers, IN 46256 | 2020-01-28 |
| 1780236620 | Amare Hospice & Palliative Care | Family Medicine | 10475 Crosspoint Boulevard, Suite 250, Indianapolis, IN 46256 | 2019-07-11 |
| 1588226864 | Accutreat LLC | Clinical Medical Laboratory | 9661 Crosspoint Blvd, Indianapolis, IN 46256 | 2019-07-08 |
| 1447732557 | Kathleen O'hara | Marriage & Family Therapist | 8202 Clearvista Pkwy Unit 7, Indianapolis, IN 46256 | 2018-09-05 |
| 1205313608 | Healing Bridges Counseling, LLC | Marriage & Family Therapist | 8465 Keystone Crossing, Suite 266, Indianapolis, IN 46256 | 2018-07-27 |
| 1477062123 | Rosalee Ann Miller | Social Worker | 8202 Clearvista Parkway, Suite 6a, Indianapolis, IN 46256 | 2017-09-26 |
| 1760900039 | Amye Litherland | Registered Nurse | 7525 E. 82nd St Ste A, Indianapolis, IN 46256 | 2017-09-06 |
| 1275074239 | Jason Dempsey | Hearing Instrument Specialist | 8202 Clearvista Pkwy 3a, Indianapolis, IN 46256 | 2017-03-10 |
| 1578922761 | Fresenius Medical Care Indiana, LLC | Clinic/Center | 7155 Shadeland Station Way, Suite 130, Indianapolis, IN 46256 | 2016-02-16 |
| 1477925071 | Samantha Kitcoff | Physician Assistant | 8180 Clearvista Pkwy Ste 100, Indianapolis, IN 46256 | 2015-10-22 |
| Find all providers in zip 46256 | ||||
| Taxonomy Code | 2086S0122X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Plastic and Reconstructive Surgery |
| A surgeon who specializes in plastic and reconstructive surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982050340 | Eric Pittelkow | Surgery | 545 Barnhill Drive Emerson Hall, Suite 232, Indianapolis, IN 46202 | 2016-05-04 |
| 1164654257 | Erin Weber | Surgery | 1801 N Senate Blvd Ste 525, Indianapolis, IN 46202-1253 | 2009-08-21 |
| 1669677142 | Jaime Marie Ranieri | Surgery | 8051 S Emerson Ave Ste 450, Indianapolis, IN 46237-8667 | 2007-06-15 |
| 1770708158 | Kimberly K Short | Surgery | 8455 Clearvista Place, Indianapolis, IN 46256-2419 | 2007-04-13 |
| 1558344697 | William A Wooden | Surgery | 260 Emerson Hall, 545 Barnhill Dr, Indianapolis, IN 46202-5200 | 2005-11-22 |
| 1699003400 | Zollman Plastic Surgery | Surgery | 8227 Northwest Blvd, Suite 290, Indianapolis, IN 46278-1387 | 2009-12-07 |
| 1285880997 | Hemant Sabharwal | Surgery | 8051 S Emerson Ave, Suite 480, Indianapolis, IN 46237-8600 | 2008-08-13 |
| 1265697973 | Sidhbh Gallagher | Surgery | 545 Barnhill Dr, Suite 232, Indianapolis, IN 46202-5112 | 2008-07-22 |
| 1982819017 | Indianapolis Institute for Plastic Surgery | Surgery | 8051 S Emerson Ave, Ste 450, Indianapolis, IN 46237-8600 | 2007-05-11 |
| 1083836332 | Indianapolis Plastic Surgeons PC | Surgery | 8330 Naab Road, Suite 140, Indianapolis, IN 46260 | 2007-05-03 |
| Find all providers in INDIANAPOLIS | ||||
| City | INDIANAPOLIS |
| Zip Code | 46256 |
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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.