MS. JUDITH LYNN WAGENSOMER PA-C
NPI 1881711224
Physician Assistant in Detroit, MI

Active since March 22, 2007
2799 W GRAND BLVD, DETROIT, MI 48202(313) 916-1545 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Ms. Judith Lynn Wagensomer Pa-c NPPES

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

MS. JUDITH LYNN WAGENSOMER PA-C (NPI 1881711224) is an individual physician assistant in Detroit, Michigan, licensed in Michigan (5601002034) and active in the NPI registry since March 2007.

NPPES Registry Identity

NPI1881711224
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameMS. JUDITH LYNN WAGENSOMERCredential: PA-C
Location Address2799 W GRAND BLVDDetroit, MI 48202-2608
Mailing Address3388 Riverside DrCanton, MI 48188-2337 · (734) 495-1232
Sole ProprietorNo
Enumeration DateMarch 22, 2007
Last NPPES UpdateJuly 8, 2007
NPI 1881711224 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License Licensed in MI · 5601002034
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
2799 W GRAND BLVD, Detroit, MI 48202

Other Providers at the Same Location NPPES 20

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

General Acute Care Hospital
2799 W GRAND BLVD
DETROIT, MI 48202
Radiology (Diagnostic Radiology)
2799 W GRAND BLVD
DETROIT, MI 48202
Radiology (Diagnostic Radiology)
2799 W GRAND BLVD
DETROIT, MI 48202
Family Medicine
2799 W GRAND BLVD
DETROIT, MI 48202
Internal Medicine (Pulmonary Disease)
2799 W GRAND BLVD
DETROIT, MI 48202
Internal Medicine (Cardiovascular Disease)
2799 W GRAND BLVD
DETROIT, MI 48202
Nurse Anesthetist, Certified Registered
2799 W GRAND BLVD
DETROIT, MI 48202
Internal Medicine (Pulmonary Disease)
2799 W GRAND BLVD
DETROIT, MI 48202

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 Judith Wagensomer's NPI number?

The NPI number for Judith Wagensomer is 1881711224. It was assigned to this individual provider in the NPPES registry on March 22, 2007.

Where is Judith Wagensomer located?

Judith Wagensomer practices at 2799 W Grand Blvd, Detroit, MI 48202. The listed phone number is (313) 916-1545.

What is Judith Wagensomer's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

When was this NPI record last updated?

The NPPES record for Judith Wagensomer was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.