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RYAN COLT WAGONER M.D. NPI 1952531204


NPI Information

NPI: 1952531204
Provider Name: RYAN COLT WAGONER, M.D.
Classification: Psychiatry & Neurology - 2084P0800X
Entity Type: Individual

Specialization: Psychiatry

Organization: UNIVERSITY MEDICAL SERVICE ASSOCIATION INC

PECOS Registration: Yes

Address:
3515 E FLETCHER AVE
MDC 14
TAMPA, FL
ZIP 33613
Phone: (813) 974-8900
Get Directions

Ryan Colt Wagoner, M.D. is a psychiatry psychiatry neurology in Tampa, FL with 15 years of experience. The provider is a Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. Ryan Colt Wagoner, M.D. NPI is 1952531204. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF FLORIDA COLLEGE OF MEDICINE
Graduation Year:2009

The provider's business location address is:

3515 E FLETCHER AVE
MDC 14
TAMPA, FL
ZIP 33613-702
Phone: (813) 974-8900

The NPI 1952531204 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 enumeration date for this NPI number is 7/21/2009 and was last updated on 3/31/2021.


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
12084F0202XPsychiatry & NeurologyForensic PsychiatryA124075CALIFORNIANo
22084P0800XPsychiatry & NeurologyPsychiatryME119037FLORIDAYes
32084P0800XPsychiatry & NeurologyPsychiatry71582GEORGIANo
4390200000XStudent in an Organized Health Care Education/Training ProgramMT194511PENNSYLVANIANo

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
1015294500MEDICAIDFLORIDA
21510AOTHERFLORIDABLUE CROSS BLUE SHIELD

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: 11/14/2023

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.