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Deactivated NPI 1497967947 Deactivated / Inactive NPI Male Practitioner

Dr. William A Wagner , DO

General Practice • Grand Rapids, MI

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. William Wagner has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date May 05, 2007
NPI Deactivation Date June 17, 2022
Total Practice Duration ~15 Years of Practice (2007 – 2022)

Professional Overview & Biography Verified Profile Summary

Dr. William Wagner, DO was a registered General Practice practicing in Grand Rapids, MI. Throughout an active medical career spanning 15 years, Dr. Wagner provided care at the practice location at 2317 ELMWOOD DR SE until profile deactivation on 2022-06-17.

Practice Location & Contact Primary Location

Practice Address

2317 Elmwood Dr Se

Grand Rapids, MI 495064055

Telephone 1616245380

Specialty Benchmarks & Practice Insights

Comparative analytics for General Practice in Grand Rapids, MI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 9.3 Yrs
State Avg: 29.4 Yrs
Regional Practice Density
12 Specialists

Practicing in Grand Rapids, MI (445 Statewide)

Telehealth Adoption Rate
8.3% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

General Practice Primary Specialty

NUCC Taxonomy Code: 208D00000X

State License MI 5101003991

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated June 17, 2022

Record deactivated on June 17, 2022

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 2317 ELMWOOD DR SE, GRAND RAPIDS, MI 495064055 (Tel: 1616245380)

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Updated Business Mailing Address July 08, 2007

Registered at 2317 ELMWOOD DR SE, GRAND RAPIDS, MI 495064055 (Tel: 1616245380)

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Provider Name / Credentials Updated July 08, 2007

Recorded as WILLIAM WAGNER, D.O.

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

General Practice (License #5101003991 in MI)

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Initial NPI Registration & Enumeration May 05, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1497967947
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 05, 2007
Last Update: July 08, 2007
Deactivation Date: June 17, 2022

Mailing Address

2317 Elmwood Dr Se

Grand Rapids, MI 495064055

Phone: 1616245380

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.