LUKE ANDREW WAGNER SOIDC
NPI 1013589407
Military Health Care Provider - Independent Duty Corpsman in Coronado, CA

Q: What is Luke Wagner's NPI number?

The NPI number for Luke Wagner is 1013589407. It was assigned to this individual provider in the NPPES registry on July 14, 2021.

Q: What is Luke Wagner's specialty?

The primary specialty registered for this NPI is Military Health Care Provider, specializing in Independent Duty Corpsman, with taxonomy code 1710I1002X.

Q: When was this NPI record last updated?

The NPPES record for Luke Wagner was last updated on July 14, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 14, 2021

917 3RD ST, CORONADO, CA 92118(305) 793-4777 Get Directions Write a Review

NPPES record last updated: July 14, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Luke Andrew Wagner Soidc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LUKE ANDREW WAGNER SOIDC (NPI 1013589407) is an individual independent duty corpsman provider in Coronado, California and active in the NPI registry since July 2021.

NPPES Registry Identity

NPI1013589407

Entity TypeIndividualMale

Primary Taxonomy1710I1002X

Provider Legal NameLUKE ANDREW WAGNERCredential: SOIDC

Location Address917 3RD STCoronado, CA 92118-1313

Mailing Address917 3rd StCoronado, CA 92118-1313 · (305) 793-4777

Phone(305) 793-4777

Sole ProprietorNo

Enumeration DateJuly 14, 2021

NPPES CertifiedJuly 14, 2021

✔ NPI 1013589407 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMilitary Health Care Provider · Independent Duty CorpsmanOther Service Providers

Taxonomy Code1710I1002X

Definition

A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals.

917 3RD ST, Coronado, CA 92118

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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Luke Wagner's NPI number?

The NPI number for Luke Wagner is 1013589407. It was assigned to this individual provider in the NPPES registry on July 14, 2021.

Where is Luke Wagner located?

Luke Wagner practices at 917 3rd St, Coronado, CA 92118. The listed phone number is (305) 793-4777.

What is Luke Wagner's specialty?

The primary specialty registered for this NPI is Military Health Care Provider, specializing in Independent Duty Corpsman, with taxonomy code 1710I1002X.

When was this NPI record last updated?

The NPPES record for Luke Wagner was last updated on July 14, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.