Blair Wagner

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

License

009605995 Issued in LA

Practice address

1501 Magnolia St # B
Slidell, LA 70460-8821

Phone

(504) 400-3896

NPI assigned

Aug 26, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Wagner'S Transportation LLC

  • Non-emergency Medical Transport (VAN)
  • Slidell, LA
  • NPI 1033869383
  NPD Authorized official

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

{
    "created_epoch": "1629936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629936000000",
    "number": "1053088005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 MAGNOLIA ST # B",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704608821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 MAGNOLIA ST # B",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704608821",
            "telephone_number": "504-400-3896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "BLAIR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-26",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "LA",
            "license": "009605995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bao Anh Jessica Cao Vu, PHARMD
• John F Vu, MD
• Martha Mary Vu, PHARMD
• Tram Anh Monique Cao Vu, DDS
• Dianna Waller Wadsworth, FNP
• Wagner'S Transportation LLC
• Katey Fitzpatrick Wahden
• Wal-Mart Stores East LP
• Wal-Mart Stores East LP
• Wal-Mart Stores East LP

• Non-emergency Medical Transport (VAN) in Slidell, LA
• Providers in Slidell, LA by specialty
• Non-emergency Medical Transport (VAN) in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2021; 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.