{"npi":"1083848030","type":"NPI-1","status":"active","name":{"display":"Bradford Wagner MD","other":[],"first":"BRADFORD","last":"WAGNER","middle":"S.","credential":"MD"},"specialty":{"primary_taxonomy":"207QS0010X","primary_taxonomy_description":"Sports Medicine (Family Medicine) Physician","slug":"sports-medicine-family-medicine-physician","schema_org_specialty":null,"all":[{"code":"207Q00000X","description":"Family Medicine","primary":false,"state":"ME","license":"MD19486"},{"code":"207QS0010X","description":"Sports Medicine (Family Medicine) Physician","primary":true,"state":"ME","license":"MD19486"}]},"addresses":[{"purpose":"LOCATION","street_1":"50 FODEN RD STE 3","city":"SOUTH PORTLAND","state":"ME","postal_code":"041061718","country_code":"US","phone":"2078741489","fax":"2075238590"},{"purpose":"MAILING","street_1":"100 GANNETT DR STE C","city":"SOUTH PORTLAND","state":"ME","postal_code":"041065900","country_code":"US","phone":"2073472947","fax":"2078742317"}],"license":{"state":"ME","number":"MD19486"},"identifiers":[],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20130913000640","type_code":"14-08","type_desc":"PRACTITIONER - FAMILY PRACTICE","state":"ME","pac_id":"1456595313"}]},"enumeration_date":"2009-05-06","last_updated":"2026-03-03","_meta":{"source":"NPPES","snapshot_date":"2026-03-03","doc_url":"https://findmynpi.com/api"}}