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DR. LAURA ELLA WAGNER M.D. NPI 1669445060


NPI Information

NPI: 1669445060
Provider Name: DR. LAURA ELLA WAGNER, M.D.
Classification: Specialist - 174400000X
Entity Type: Individual

PECOS Registration: Yes

CLIA Number: 26D0943616

Address:
14377 WOODLAKE DR
SUITE 111
CHESTERFIELD, MO
ZIP 63017
Phone: (314) 434-1111
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DR. Laura Ella Wagner, M.D. is a specialist in Chesterfield, MO with 35 years of experience. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. DR. Laura Ella Wagner, M.D. NPI is 1669445060. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: WASHINGTON UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:1989

The provider's business location address is:

14377 WOODLAKE DR
SUITE 111
CHESTERFIELD, MO
ZIP 63017-735
Phone: (314) 434-1111
Fax: (314) 434-1112

The NPI 1669445060 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The CLIA number assigned to this NPI record is 26D0943616 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Destruction of 2-14 skin growths (HCPCS:17003)
  • Destruction of skin growth (HCPCS:17000)
  • Tangential biopsy of single skin lesion (HCPCS:11102)
  • Tangential biopsy of additional skin lesion (HCPCS:11103)
  • Destruction of up to 14 skin growths (HCPCS:17110)

The enumeration date for this NPI number is 2/8/2006 and was last updated on 5/24/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1174400000XSpecialistR8N01MISSOURIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
118374OTHERMISSOURIBCBSMO PROVIDER #
2211386OTHERMISSOURIHEALTHLINK ID#
3000094839MEDICARE ID-TYPE UNSPECIFIEDMISSOURI
4F58335MEDICARE UPINMISSOURI
539228V39228OTHERMISSOURIGHP PROVIDER #
64420124OTHERMISSOURIAETNA PROVIDER #
7431895147OTHERMISSOURITAX ID#

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.