Kathryn Wagner

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

H14076939 Issued in NE

Practice address

9030 Western Ave
Omaha, NE 68114-2265

Phone

(402) 390-8207

NPI assigned

Feb 6, 2025

Sex

Female

Sole proprietor

No

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

Locations

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.

• Westside Community Schools Foundation Inc.

  • Child Physical Disabilities Respite Care
  • Omaha, NE
  • NPI 1396543740
  NPD

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

{
    "created_epoch": "1738800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738800000000",
    "number": "1144034315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1921 S 149TH CIR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681442005",
            "telephone_number": "402-740-8736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9030 WESTERN AVE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681142265",
            "telephone_number": "402-390-8207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "KATHRYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-06",
        "last_updated": "2025-02-06",
        "certification_date": "2025-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NE",
            "license": "H14076939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dawn G Wagner, LMT, BCTMB
• Elaine Patricia Wagner
• Jason Rutledge Wagner II
• Jill Wagner
• Julie Dianne Wagner
• Kelsey Jo Wagner
• Kristin Nicole Wagner, LMHP, CMSW
• Micah C Wagner
• Natalie A Wagner, LIMHP, LADC
• Noel C Wagner, PT, DPT

• Student in an Organized Health Care Education/Training Program in Omaha, NE
• Providers in Omaha, NE by specialty
• Student in an Organized Health Care Education/Training Program in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2025; 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.