DR. WAYNE L WAGONER DPM NPI 1508079138

NPI Information

  • NPI: 1508079138
  • Provider Name: DR. WAYNE L WAGONER, DPM
  • Classification: Podiatrist - 213E00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 515 ROSEMERE LN
    MAQUOKETA, IA
    ZIP 52060
  • Phone: (563) 652-9777

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NPI Details

DR. Wayne L Wagoner, DPM is a podiatrist in Maquoketa, IA. The provider is a podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. DR. Wayne L Wagoner, DPM NPI is 1508079138. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

515 ROSEMERE LN
MAQUOKETA, IA
ZIP 52060-615
Phone: (563) 652-9777
Fax: (563) 652-9778

The NPI 1508079138 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS).

The enumeration date for this NPI number is 5/8/2007 and was last updated on 7/8/2007.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1213E00000XPodiatrist00526IOWAYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11083683MEDICAIDIOWA
255011MEDICARE ID-TYPE UNSPECIFIEDIOWA

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: 11/21/2025

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