DR. TRAVIS RAY WAGNER (NPI# 1932635653) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932635653 |
| Entity Type | Individual |
| Full Name | DR. TRAVIS RAY WAGNER |
| Credential | CAPT |
| Practice Address |
86th Medical Group Unit 3215 Apo AE 09094-3215 |
| Practice Telephone | 8043379700 |
| Mailing Telephone | 8043379700 |
| Enumeration Date | 2017-05-02 |
| Last Update Date | 2020-10-07 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
0401415734 | VA | Dental Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 14th Medical Group 201 Independence Drive, Columbus, MS 39710 | 6624342273 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508358953 | Travis Wagner | Student in an Organized Health Care Education/Training Program | 1616 13th Ave Ste 200, Huntington, WV 25701-3840 | 2018-06-01 |
| Street Address |
86TH MEDICAL GROUP UNIT 3215 |
| City | APO |
| State | AE |
| Zip Code | 09094-3215 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689959736 | Caleb Rink | Optometrist | 86th Medical Group, Unit 3215, Apo, AE 09094-3215 | 2011-10-19 |
| 1699394171 | Brenden Michael Lee Fowler | Military Health Care Provider | 86th Medical Group, Unit 3215, Apo, AE 09094 | 2020-04-14 |
| 1972122430 | Taylor Austin Thompson | Military Health Care Provider | 86th Medical Group, Unit 3215, Apo, AE 09094 | 2020-04-14 |
| 1972066918 | Emily H Mercante | Military Health Care Provider | 86th Medical Group, Unit 3215, Apo, AE 09094 | 2019-04-08 |
| 1174976674 | Bryan Caine | Dentist | 86th Medical Group, Unit 3215, Apo, AE 09094-3215 | 2016-07-20 |
| 1518327691 | Stephan Javaheri | Dentist | 86th Medical Group, Unit 3215, Apo, AE 09094-3215 | 2016-03-02 |
| 1275906059 | Jennifer Malloy | Dentist | 86th Medical Group, Ramstein Ab, Germany, Apo, AE 09012 | 2015-11-03 |
| 1215357389 | Lindsey Tyler Leitz | Dietitian, Registered | 86th Medical Group, Unit 3215, Apo, AE 09094 | 2014-04-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043722077 | Claudia Kayatani | Social Worker | Ramstein Afb, 86th Mdg, Apo, AE 09094 | 2017-10-31 |
| 1073993549 | Philip Oro | Family Medicine | Psc 2, Unit 3215, Bldg 2114, Room 201, Apo, RAMSTEIN-MIESENBACH 09094 | 2015-06-01 |
| 1336528363 | Talon Miner | Preventive Medicine | 86 Amds / Sgpf, Flight Surgeon Office Unit 3215, Apo, AE 09094 | 2015-05-22 |
| 1578973921 | Joseph Lincoln Abrams | Preventive Medicine | 86 Amds Unit 3212, Apo, AE 09094 | 2014-05-06 |
| 1063756575 | Bethany Allison Casper | Nurse Practitioner | Ramstein Air Base, 86 Mdg, Apo, AE 09094 | 2012-11-21 |
| 1871846113 | Adam P Faber | Nurse Practitioner | 86mdg, Unit 3215, Apo, AE 09094 | 2012-10-24 |
| 1982959771 | Matthew Puderbaugh | General Practice | 86th Medical Group Unit 3215, Apo, AE 09094 | 2012-07-17 |
| 1760757371 | Nathan Larson | Dentist | 86ds/sgd, Unit 3215, Apo, AE 09094 | 2012-03-14 |
| 1609004589 | Lashonda M Green Morehead | Military Health Care Provider | 435 Th Mdos/sgopf, Unit 3215 Ramstein Ab, Germany, Apo, AE 09094 | 2009-06-30 |
| 1952588766 | Denise Maria Martin Zona | Counselor | 86 Mdos/sgow, Unit 3215, Apo, AE 09094 | 2008-01-23 |
| Find all providers in zip 09094 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154938520 | Jacob Steven Blackhurst | Dentist | Bldg 4-1838 Normandy Dr, Apo, AA 28307-7302 | 2020-09-29 |
| 1669088852 | Matthew Dejong | Dentist | Kleber Dental Clinic, Bldg 3287, Apo, AE 09227 | 2020-09-22 |
| 1184236895 | Christina Belousov | Dentist | 14351 Battalion Ave, Apo, AA 76544 | 2020-08-24 |
| 1417503459 | Cooper Pasque | Dentist | 1838 Normandy Dr., Fort Bragg, Apo, AA 28310 | 2019-08-15 |
| 1659927937 | Benjamin Kyunghan Yoon | Dentist | 618th Dental Company, Carius Dental Clinic Unit #15652, Attn: Credentails Coordinator, Apo, AP 96271-5245 | 2019-08-13 |
| 1477108967 | Shane Clay Hoffner | Dentist | 618th Dental Co, Carius Dental Clinic Bldg# P3020, Attn: Credentials Office, Apo, AP 96271-5245 | 2019-08-02 |
| 1740848449 | Samuel Kong Hmong Lo | Dentist | Carius Dental Clinic, Unit 15652, Apo, AP 96271 | 2019-05-29 |
| 1437712130 | Andrea Rose Deese | Dentist | Raf Lakenheath 48 Mdg / Sghc, Unit 5115, Apo, AE 09461-5115 | 2019-04-17 |
| 1871052837 | Ryan Kenny Zarnowski | Dentist | 673 Mdg, 5955 Zeamer Avenue, Jber, Ak 99506, Apo, AA 99506 | 2019-03-18 |
| 1619440922 | Joo Park | Dentist | Cmr 402 Unit 33301, Apo, AE 09180 | 2019-01-09 |
| Find all providers in APO | ||||
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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.