Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Jacob Lewis Wagner, DO

Individual provider Diagnostic Radiology Physician · NPI 1356922959

Dr. Jacob Lewis Wagner, DO is a Diagnostic Radiology in Durham, North Carolina. Graduated from University of New England, College of Osteo Medicine in 2021, 5 years ago. Licensed in North Carolina.

Years since qualifying
5
Trained at
University of New England, College of Osteo Medicine
Licensed in
NC
In the registry since
2021
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

2301 Erwin Rd
Durham, NC 27705-4699
Phone: (919) 684-8111
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence 2025-04156 (NC)

Record details

NPI number1356922959
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedApril 16, 2021
Last updated in NPPESJune 18, 2026
Certification dateJune 18, 2026
Mailing addressPo Box 63362, Charlotte, NC 28263-3362

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDIAGNOSTIC RADIOLOGY
Medical schoolUNIVERSITY OF NEW ENGLAND, COLLEGE OF OSTEO MEDICINE
Graduated 2021 (5 years in practice)
Accepts Medicare assignment Not indicated

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