NPIMap

Organization Active NPI

Linda Wagner LLC

  • Occupational Therapist
  • Erie, PA
National Provider Identifier
1043853112
Registry record updated Oct 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
LINDA WAGNER LLC
Practice address
5216 Dorchester Dr
Erie, PA 16509-2500
Phone
(585) 503-0405
NPI assigned
Oct 22, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Linda Wagner, MS, OTR/LNPI 1750404315
Title
Owner-Therapist
Phone
(585) 503-0405

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X Primary

Addresses

Primary practice location

5216 Dorchester Dr
Erie, PA 16509-2500

Mailing address

5216 Dorchester Dr
Erie, PA 16509-2500
Phone (585) 503-0405

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1571702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571702400000",
    "number": "1043853112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5216 DORCHESTER DR",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165092500",
            "telephone_number": "585-503-0405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5216 DORCHESTER DR",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165092500",
            "telephone_number": "585-503-0405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINDA WAGNER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-22",
        "last_updated": "2019-10-22",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "OWNER-THERAPIST",
        "authorized_official_telephone_number": "585-503-0405",
        "authorized_official_credential": "MS, OTR/L"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.