Individual provider Active NPI

Lindsy Kae Yarger-Wagner, PSYD

  • Psychologist
  • Christiansted, VI
National Provider Identifier
1124273412
Registry record updated Jan 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PS016535 Issued in PA
Practice address
5030 Anchor Way Ste 9
Christiansted, VI 00820-4692
Phone
(340) 719-7007
Fax
(340) 719-6655
NPI assigned
Dec 1, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 09-28-PSY VI
Psychologist 103T00000X PS016535 PA Primary

Addresses

Primary practice location

5030 Anchor Way Ste 9
Christiansted, VI 00820-4692

Mailing address

5030 Anchor Way Ste 9
Christiansted, VI 00820-4692
Phone (340) 719-7007

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180720000734 VI Practitioner - Clinical Psychologist 4082961180 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lindsy Wagner LLCGroup PAC ID 3476800574, 16 clinicians

Practice addresses (Care Compare)

5030 Anchor Way
Christiansted, VI 00820-4692
Phone (340) 719-7007

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PS016535PAMDPsychologist
09-28-PSYVIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Lindsy Wagner LLC CurrentSince Mar 22, 2018 Accepting new patients
Prospect Hill Recovery and Wellness LLC Current Accepting new patients

Locations

5030 Anchor Way
Ste 9
Christiansted, VI 00820
Phone (340) 277-4995

5030 Anchor Way
Ste 7
Christiansted, VI 00820
Phone (973) 280-4006

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1228089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578614400000",
    "number": "1124273412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5030 ANCHOR WAY STE 9",
            "city": "CHRISTIANSTED",
            "state": "VI",
            "postal_code": "008204692",
            "telephone_number": "340-719-7007",
            "fax_number": "340-719-6655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5030 ANCHOR WAY STE 9",
            "city": "CHRISTIANSTED",
            "state": "VI",
            "postal_code": "008204692",
            "telephone_number": "340-719-7007",
            "fax_number": "340-719-6655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YARGER-WAGNER",
        "first_name": "LINDSY",
        "middle_name": "KAE",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-01",
        "last_updated": "2020-01-10",
        "certification_date": "2020-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "VI",
            "license": "09-28-PSY",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS016535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Christiansted, VI

Sources for this page

Verify at the official NPI Registry.