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

Last updated

Dec 7, 2012By the provider in NPPES

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mustard Seed Autism Project, Inc

  dba ABA Academy

  • 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 (Walmart Pharmacy 10-3594)
• Darrell Wharton
• Nicole Ashley Whitby
• Fiona Mona Whitehead, M.ED, LPC
• William Lay DDS PLLC (Pantego Dental and Orthodontics Center)

• 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.