Madeline Wagnon, M.S., CFY-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

2580 E Joyce Blvd Ste 12
Fayetteville, AR 72703-3924

Phone

(479) 521-7337

Fax

(479) 521-7338

NPI assigned

Aug 5, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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.

• Lynn M Center, Inc

  • Speech-Language Pathologist
  • Fayetteville, AR
  • NPI 1104909860
  NPD (past)

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

{
    "created_epoch": "1564963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564963200000",
    "number": "1184279309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2580 E JOYCE BLVD STE 12",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727033924",
            "telephone_number": "479-521-7337",
            "fax_number": "479-521-7338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2580 E JOYCE BLVD STE 12",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727033924",
            "telephone_number": "479-521-7337",
            "fax_number": "479-521-7338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNON",
        "first_name": "MADELINE",
        "credential": "M.S., CFY-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-05",
        "last_updated": "2019-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Fayetteville",
            "affiliation": "N",
            "address_1": "2580 E Joyce Blvd Ste 12",
            "city": "Fayetteville",
            "state": "AR",
            "country_code": "US",
            "postal_code": "727033924",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Hannah Elizabeth Waggener
• Michael Waggoner, O.D.
• Alicia D Wagner
• Lindsey Lea Wagner, LCSW
• Tommy Wagner III
• Rachel Elizabeth Wagoner
• Lara Lamastus Waite, DPT PT
• Allie Frances Wakefield, LPEI
• Wal-Mart Stores, Inc
• Wal-Mart Stores, Inc.

• Speech-Language Pathologist in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• Speech-Language Pathologist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2019; 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.