CLAYTON THOMAS WAGNER (NPI# 1902303589) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902303589 |
| Entity Type | Individual |
| Full Name | CLAYTON THOMAS WAGNER |
| Practice Address |
1100 Delaplaine Ct Madison WI 53715-1840 |
| Practice Telephone | 6082634550 |
| Practice Fax Number | 6082635813 |
| Mailing Telephone | 6082634550 |
| Mailing Fax Number | 6082635813 |
| Enumeration Date | 2018-04-10 |
| Last Update Date | 2018-04-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
1100 DELAPLAINE CT |
| City | MADISON |
| State | WI |
| Zip Code | 53715-1840 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760648026 | Shannon Caryn Reed | Family Medicine | 1100 Delaplaine Ct, Madison, WI 53715-1840 | 2008-08-05 |
| 1124680764 | Pamela Falcon | Student in an Organized Health Care Education/Training Program | 1100 Delaplaine Ct, Madison, WI 53715-1840 | 2019-07-03 |
| 1821650466 | Jordan Fraser | Student in an Organized Health Care Education/Training Program | 1100 Delaplaine Ct, Madison, WI 53715-1840 | 2019-07-03 |
| 1174083612 | Markus A Eckstein | Student in an Organized Health Care Education/Training Program | 1100 Delaplaine Ct, Attn: Orsolya Szecsi, Madison, WI 53715-1840 | 2019-03-21 |
| 1760942221 | Joseph E Zbaracki | Student in an Organized Health Care Education/Training Program | 1100 Delaplaine Ct, Attn: Orsolya Szesi, Madison, WI 53715 | 2019-03-21 |
| 1750841201 | Jonathan M Rief | Student in an Organized Health Care Education/Training Program | 1100 Delaplaine Ct, Attn: Orsolya Szecsi, Madison, WI 53715 | 2019-03-21 |
| 1629575394 | Cody James Howe | Student in an Organized Health Care Education/Training Program | 1100 Delaplaine Ct, Madison, WI 53715-1840 | 2018-04-10 |
| 1669979449 | Kiesha M. Bullock | Student in an Organized Health Care Education/Training Program | 1100 Delaplaine Ct, Madison, WI 53715-1840 | 2018-04-09 |
| 1467959353 | John Yeakel | Student in an Organized Health Care Education/Training Program | 1100 Delaplaine Ct, Madison, WI 53715-1840 | 2018-04-09 |
| 1841797800 | Courtney Rae Reynolds | Student in an Organized Health Care Education/Training Program | 1100 Delaplaine Ct, Madison, WI 53715-1840 | 2018-04-06 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851807697 | Kristi M Batchelor | Nurse Practitioner | 20 S Park St Fl 4, Madison, WI 53715 | 2017-12-15 |
| 1578927026 | Petra A Kelsey | Family Medicine | 1107 Emerald St, Madison, WI 53715 | 2016-04-11 |
| 1467889238 | Group Health Cooperative of South Central Wi | Durable Medical Equipment & Medical Supplies | 740 Regent Street, Suite 106, Madison, WI 53715 | 2013-10-10 |
| 1275888760 | Sandra Beth Miller | Physician Assistant | 700 S. Park, Suite A 404, Madison, WI 53715 | 2012-07-20 |
| 1134418486 | Matthew Lochen | Emergency Medicine | 700 S. Park Street, Department of Emergency Medicine, Madison, WI 53715 | 2011-04-06 |
| 1225275720 | Eileen J Breitweiser | Social Worker | 202 South Parkt Street, Madison, WI 53715 | 2009-01-21 |
| 1225293137 | Kenneth H. Yuska, Md, Sc | Orthopaedic Surgery | 4726 East Towne Blvd., 110, Madison, WI 53715 | 2008-07-21 |
| 1063689727 | Rachel I Kornik | Dermatology | Uw Health Dept of Dermatology 1 S. Park St, Administrative Office 7th Floor, Madison, WI 53715 | 2008-05-13 |
| 1144434911 | Rebecca Sue Frye | Pharmacist | 1 South Park Street, Suite 101 Pharmacy, Madison, WI 53715 | 2007-05-10 |
| 1376755496 | Eileen C. Scrivner | Social Worker | 1008 Fish Hatchery Road, Madison, WI 53715 | 2007-05-03 |
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| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982204442 | Stephanie Copeland | Student in an Organized Health Care Education/Training Program | 2508 Castor Ln, Madison, IN 47250-2496 | 2020-10-26 |
| 1275130213 | Najla Ba Sharahil | Student in an Organized Health Care Education/Training Program | 600 Highland Avenue University of Wisconsin Hospitals A, Office H4/466, Madison, WI 53792-4108 | 2020-10-02 |
| 1992319321 | Caraline Putnam Walker | Student in an Organized Health Care Education/Training Program | 186 Forest Lake Dr, Madison, MS 39110-9428 | 2020-09-02 |
| 1902416969 | Cynthia Iradukunda | Student in an Organized Health Care Education/Training Program | University of Wisconsin School of Medicine and Public H, 600 Highland Ave, B6/319, Madison, WI 53792 | 2020-08-05 |
| 1215551932 | Kirsten Mccullough | Student in an Organized Health Care Education/Training Program | Uw Health University Hospital 600 Highland Ave, Madison, WI 53792-0001 | 2020-05-29 |
| 1467073783 | David Pontes | Student in an Organized Health Care Education/Training Program | 4906 Odana Rd, Madison, WI 53711-1337 | 2020-04-27 |
| 1154941672 | Olawale Temitope Oduru | Student in an Organized Health Care Education/Training Program | 600 Highland Ave. Uw Hospitals & Clinics, Madison, WI 53792-0001 | 2020-04-24 |
| 1730708298 | Raha Amini | Student in an Organized Health Care Education/Training Program | 470 Fairfield Dr, Madison, MS 39110-7543 | 2020-04-14 |
| 1306465026 | Allison Blumenfeld | Student in an Organized Health Care Education/Training Program | Uw Hospital & Clinics 600 Highland Ave, Madison, WI 53792-0001 | 2020-04-13 |
| 1205465291 | Jennifer A Mirrielees | Student in an Organized Health Care Education/Training Program | Uw Hospital 600 Highland Avenue, Madison, WI 53792-0001 | 2020-04-02 |
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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.