Nancy Wagner, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-07-3398 Issued in TX

Practice address

3605 W Pioneer Pkwy
Suite C
Pantego, TX 76013-4598

Phone

(817) 277-8870

Fax

(817) 277-8875

NPI assigned

Dec 7, 2012

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

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.

• Mustard Seed Autism Project, Inc

  • Behavior Analyst
  • Arlington, TX
  • NPI 1841409158
  NPD (past) Authorized official

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

{
    "created_epoch": "1354838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354838400000",
    "number": "1164767752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14597",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760941597",
            "telephone_number": "817-277-8870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3605 W PIONEER PKWY",
            "address_2": "SUITE C",
            "city": "PANTEGO",
            "state": "TX",
            "postal_code": "760134598",
            "telephone_number": "817-277-8870",
            "fax_number": "817-277-8875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "NANCY",
        "name_prefix": "Mrs.",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-07",
        "last_updated": "2012-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "TX",
            "license": "1-07-3398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shaquita Yvonne Verser
• Verser'S Warm Hearts Homecare Agency LLC
• Vicki'S Making Faces
• Rachel Elizabeth Vinyard, PT, DPT, MPT, OCS
• Vivify Counseling and Coaching PLLC
• Wal-Mart Stores Texas LLC
• Darrell Wharton
• Nicole Ashley Whitby
• Fiona Mona Whitehead, M.ED, LPC
• William Lay DDS PLLC

• Behavior Analyst in Pantego, TX
• Providers in Pantego, TX by specialty
• Behavior Analyst in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2012; 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.