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DIANE JORDAN-WAGNER M.D. NPI 1013025097


NPI Information

NPI: 1013025097
Provider Name: DIANE JORDAN-WAGNER, M.D.
Classification: Internal Medicine - 207RA0201X
Entity Type: Individual

Specialization: Allergy & Immunology

PECOS Registration: Yes

Address:
1429 N 6TH ST
TERRE HAUTE, IN
ZIP 47804
Phone: (812) 232-0564
Get Directions

Diane Jordan-wagner, M.D. is an allergy and immunology internal medicine in Terre Haute, IN. The provider is an internist doctor of osteopathy that specializes in the treatment of allergy and immunologic disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Special Qualifications in the field of Allergy & Immunology. Diane Jordan-wagner, M.D. NPI is 1013025097. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1429 N 6TH ST
TERRE HAUTE, IN
ZIP 47804-037
Phone: (812) 232-0564
Fax: (812) 235-3330

The NPI 1013025097 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 8/29/2006 and was last updated on 3/14/2013.


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
1207RA0201XInternal MedicineAllergy & Immunology36106006ILLINOISNo
2207RA0201XInternal MedicineAllergy & Immunology01056292AINDIANAYes

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
1859910OOOOMEDICARE PININDIANA
2265130YYYMEDICARE PININDIANA
3H77028MEDICARE UPIN
4230650GMEDICARE PININDIANA
5000000230225OTHERANTHEM
6200392780QMEDICAIDINDIANA
7P00844293OTHERINDIANARAILROAD MEDICARE
8841040FFMEDICARE PININDIANA
9030005377OTHERRAILROAD MCARE PALAMETTO
10200392780MEDICAIDINDIANA
11192770RRRMEDICARE PININDIANA
12859920SMEDICARE PININDIANA
13L98357MEDICARE PINILLINOIS

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: 5/5/2024

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.