Active NPI
Barbara Lynette Wagner, MOTR/L
- Occupational Therapist
- Salem, OR
National Provider Identifier
1003143009
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 252548
- Practice address
- 820 Cottage St NE
Salem, OR 97301-2426 - Phone
- (503) 399-0202
- NPI assigned
- Nov 11, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 252548 | OR | Primary |
Addresses
Primary practice location
820 Cottage St NE
Salem, OR 97301-2426
Mailing address
1824 Denali Dr E
Monmouth, OR 97361-1883
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 252548 | OR | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1257897600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1257897600000",
"number": "1003143009",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1824 DENALI DR E",
"city": "MONMOUTH",
"state": "OR",
"postal_code": "973611883"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "820 COTTAGE ST NE",
"city": "SALEM",
"state": "OR",
"postal_code": "973012426",
"telephone_number": "503-399-0202"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGNER",
"first_name": "BARBARA",
"middle_name": "LYNETTE",
"name_prefix": "Miss",
"credential": "MOTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-11-11",
"last_updated": "2009-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "OR",
"license": "252548",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salem, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.