DR. KELLY WAGNER (NPI# 1932510831) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932510831 |
| Entity Type | Individual |
| Full Name | DR. KELLY WAGNER |
| Credential | PHARM.D |
| Practice Address |
3360 Tittabawassee Rd Saginaw MI 48604-9453 |
| Mailing Address |
4094 W Crossings Saginaw MI 48603-8710 |
| Practice Telephone | 9892496033 |
| Enumeration Date | 2014-05-13 |
| Last Update Date | 2014-05-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P1200X |
Pharmacist Specialization: Pharmacotherapy |
5302037176 | MI | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013570746 | Kelly Susan Wagner | Speech-Language Pathologist | 8902 Old Harford Rd, Baltimore, MD 21234-2646 | 2019-04-18 |
| 1356808455 | Kelly Mcmahon Wagner | Social Worker | 4701 Greenspring Ave, Baltimore, MD 21209-4704 | 2019-02-25 |
| 1659744316 | Kelly Ann Wagner | Nurse Practitioner | 10410 Abercorn Expressway, Savannah, GA 31419 | 2015-11-03 |
| 1659612745 | Kelly Ann Wagner | Specialist | 727 Carmen Dr, Norristown, PA 19401-3545 | 2013-03-14 |
| 1881925592 | Kelly Danielle Wagner | Physical Therapy Assistant | 226 Fish Hall Rd, Brunswick, GA 31523-7405 | 2010-01-20 |
| 1407180268 | Kelly Ann Wagner | Licensed Practical Nurse | 1143 Vogt Dr Apt 14, West Bend, WI 53095-5505 | 2009-09-28 |
| 1295288629 | Kelly Wagner | Dietitian, Registered | 200 Hawkins Dr, Food and Nutrition Services, W146 Gh, Iowa City, IA 52242-1009 | 2016-08-02 |
| 1154776334 | Kelly Wagner | Student in an Organized Health Care Education/Training Program | 100 High St, C 378, Buffalo, NY 14203-1126 | 2016-04-26 |
| 1346613205 | Kelly Wagner | Naturopath | 185 Tilley Dr, Suite #51, South Burlington, VT 05403-4484 | 2015-11-01 |
| 1235562307 | Kelly Anne Wagner | Speech-Language Pathologist | 331 E Park St, Weiser, ID 83672-2053 | 2013-08-13 |
| Street Address |
3360 TITTABAWASSEE RD |
| City | SAGINAW |
| State | MI |
| Zip Code | 48604-9453 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144360694 | Meijer Inc | Durable Medical Equipment & Medical Supplies | 3360 Tittabawassee Rd, Saginaw, MI 48604-9453 | 2007-02-07 |
| 1457969594 | Travis Ommodt | Pharmacist | 3360 Tittabawassee Rd, Saginaw, MI 48604-9453 | 2020-07-15 |
| 1881126597 | Covenant Medical Center, Inc | Clinic/Center | 3360 Tittabawassee Rd, Saginaw, MI 48604-9453 | 2017-03-31 |
| 1750742185 | Carolyn Eggerd | Pharmacist | 3360 Tittabawassee Rd, Saginaw, MI 48604-9453 | 2016-03-12 |
| 1407264757 | Andrew Aylsworth | Pharmacist | 3360 Tittabawassee Rd, Saginaw, MI 48604 | 2014-07-31 |
| 1548671795 | Raghavendra Makam | Pharmacist | 3360 Tittabawassee Rd, Saginaw, MI 48604-9453 | 2014-05-09 |
| 1063822534 | Diane Lynette Garbe | Pharmacist | 3360 Tittabawassee Rd, Saginaw, MI 48604-9453 | 2014-05-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366090318 | Paulette Marie Giltrop | Technician | 2930 Eddy St, Saginaw, MI 48604 | 2019-09-03 |
| 1821419797 | Kathleen Klonowski, Dds and Ashly Bailey, Dds, Plc | Clinic/Center | 4685 E. Mcleod Dr., Saginaw, MI 48604 | 2013-12-19 |
| 1245508811 | Universal Health Group, Inc | Chiropractor | 4700 East Mcleod, Saginaw, MI 48604 | 2011-12-09 |
| 1982980751 | Vivid Idea Rehab | Home Health | 2101 West Stoker Dr, Saginaw, MI 48604 | 2011-10-25 |
| 1518266683 | Rashad H Leflore | Driver | 1293 Tittabawassee Rd Apt G, Saginaw, MI 48604 | 2011-03-15 |
| 1033392089 | Raquel N. Dorin | Physical Therapist | 2716 Liberty, Saginaw, MI 48604 | 2007-12-13 |
| 1760604854 | Matthew Thomas Kisabeth | Optometrist | 5650 Bay Road, Saginaw, MI 48604 | 2007-05-02 |
| 1861613556 | Loretta O'donnell | Pathology | 4705 Towne Centre Road, Suite 301, Saginaw, MI 48604 | 2007-05-01 |
| 1265652325 | Tracey M Mallek | Physical Therapist | 4901 Town Center Rd, Suite 300, Saginaw, MI 48604 | 2007-04-30 |
| 1588783062 | Harprabhjit Singh | Internal Medicine | 4680 Mcleod Dr E., Saginaw, MI 48604 | 2007-03-28 |
| Find all providers in zip 48604 | ||||
| Taxonomy Code | 1835P1200X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacotherapy |
| A licensed pharmacist who has demonstrated specialized knowledge and skill in optimizing pharmacotherapeutic care of patients, by developing, implementing, monitoring, and modifying complex treatment plans, providing advanced level education and consultation, and collaborating with other health professionals in the management of therapy. |
| Notes: Source: Specialty certification and recertification program administered by Board of Pharmaceutical Specialties, www.bpsweb.org [7/1/2006: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437141603 | Marilyn Sue Kamp | Pharmacist | 1500 Weiss St, (traverse City Va Outpatient Clinic), Saginaw, MI 48602-5251 | 2005-08-16 |
| 1457969594 | Travis Ommodt | Pharmacist | 3360 Tittabawassee Rd, Saginaw, MI 48604-9453 | 2020-07-15 |
| 1598388613 | Jacqueline White-neslund | Pharmacist | 800 S Washington Ave, Saginaw, MI 48601-2551 | 2020-05-22 |
| 1881249969 | Tyler Mitchell Reid | Pharmacist | 8400 Gratiot Rd, Saginaw, MI 48609-4804 | 2019-08-06 |
| 1548671795 | Raghavendra Makam | Pharmacist | 3360 Tittabawassee Rd, Saginaw, MI 48604-9453 | 2014-05-09 |
| 1467862722 | Dale Wayne Caverly | Pharmacist | 8400 Gratiot Rd, Saginaw, MI 48609-4804 | 2014-05-07 |
| 1063822534 | Diane Lynette Garbe | Pharmacist | 3360 Tittabawassee Rd, Saginaw, MI 48604-9453 | 2014-05-05 |
| 1326458183 | Bryan Cook | Pharmacist | 8400 Gratiot Rd, Saginaw, MI 48609-4804 | 2014-05-02 |
| 1255429163 | Paul Thill | Pharmacist | 700 Cooper Ave, 2nd Floor Pharmacy, Saginaw, MI 48602-5383 | 2006-10-10 |
| 1669566618 | Beth A Boyce | Pharmacist | 1500 Weiss St, Saginaw, MI 48602-5251 | 2006-10-03 |
| Find all providers in SAGINAW | ||||
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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.