Active NPI
Rebecca A Wagers, CDCA
- Community Health Worker
- Mansfield, OH
National Provider Identifier
1174978183
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- License
- 140925
- Practice address
- 28 Park Avenue West
Suite 300
Mansfield, OH 44902 - Phone
- (419) 522-5015
- Fax
- (419) 522-5017
- NPI assigned
- Apr 27, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | 140925 | OH | Primary |
Addresses
Primary practice location
28 Park Avenue West
Suite 300
Mansfield, OH 44902
Mailing address
28 Park Ave W
Suite 300
Mansfield, OH 44902-1648
Phone (419) 522-5015
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 140925 | Other | OH | OHIO CHEMICAL DEPENDENCY PROFESSIONALS BOARD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 140925 | OH | MD | Community Health Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1461715200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1461715200000",
"number": "1174978183",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28 PARK AVE W",
"address_2": "SUITE 300",
"city": "MANSFIELD",
"state": "OH",
"postal_code": "449021648",
"telephone_number": "419-522-5015",
"fax_number": "419-522-5017"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28 PARK AVENUE WEST",
"address_2": "SUITE 300",
"city": "MANSFIELD",
"state": "OH",
"postal_code": "44902",
"telephone_number": "419-522-5015",
"fax_number": "419-522-5017"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGERS",
"first_name": "REBECCA",
"middle_name": "A",
"credential": "CDCA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-04-27",
"last_updated": "2016-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "OH",
"license": "140925",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OHIO CHEMICAL DEPENDENCY PROFESSIONALS BOARD",
"identifier": "140925",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mansfield, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.