DR. LORI B WAGNER D.O.
NPI 1164601936
Family Medicine in Tampa, FL

Q: What is Lori Wagner's NPI number?

The NPI number for Lori Wagner is 1164601936. It was assigned to this individual provider in the NPPES registry on October 30, 2007.

Q: What is Lori Wagner's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Lori Wagner was last updated on October 18, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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 October 30, 2007PECOS Enrolled

1502 E FOWLER AVE, TAMPA, FL 33612(813) 866-0950(813) 866-0929 Get Directions Write a Review

NPPES record last updated: October 18, 2010. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Dr. Lori B Wagner D.o. NPPES

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

DR. LORI B WAGNER D.O. (NPI 1164601936) is an individual family medicine provider in Tampa, Florida, licensed in Florida (OS6338) and active in the NPI registry since October 2007. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1164601936

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameDR. LORI B WAGNERCredential: D.O.

Location Address1502 E FOWLER AVETampa, FL 33612-5416

Mailing Address3905 Appletree DrValrico, FL 33594-4316 · (813) 689-6051

Phone(813) 866-0950

Fax(813) 866-0929

Sole ProprietorNo

Enumeration DateOctober 30, 2007

Last NPPES UpdateOctober 18, 2010

✔ NPI 1164601936 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in FL · OS6338

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

1502 E FOWLER AVE, Tampa, FL 33612

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Other Identifiers 1

Medicare UPINE86314FL

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Lori B Wagner D.o. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33612 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$87.62 typical visit price

range $56.00 – $171.84

Typical copayment $21.90 (range $14.00 – $42.96)

Most-billed visit code 99203

Established Patient

$99.16 typical visit price

range $17.57 – $139.16

Typical copayment $24.79 (range $4.39 – $34.79)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RANDI MARIE BUSTIN PA

Physician Assistant