Paige Ann Wacker, C. HT.

Primary specialty

SpecialistTaxonomy code 174400000X

License

204-214 Issued in NM

Practice address

820 S Main St
Stillwater, OK 74074-4631

Phone

(405) 564-4766

Fax

(405) 533-4343

NPI assigned

Feb 12, 2009

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1234396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234396800000",
    "number": "1194964254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 S MAIN ST",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740744631",
            "telephone_number": "405-564-4766",
            "fax_number": "405-533-4343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 S MAIN ST",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740744631",
            "telephone_number": "405-564-4766",
            "fax_number": "405-533-4343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WACKER",
        "first_name": "PAIGE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "C. HT.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-12",
        "last_updated": "2009-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NM",
            "license": "204-214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diane Vincent, D.D.S.
• Kylie Michelle Vincent, RN
• Krystal Marie Dickens Voight, MD
• Danyeal Vontress
• Shellie Vorland
• Milynda Wade, LPC
• Samantha Ann Wagner, ATC, LAT, CES
• Hope Cherese Waid
• Tommy Len Waite
• Wal-Mart Stores East , LP

• Specialist in Stillwater, OK
• Providers in Stillwater, OK by specialty
• Specialist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2009; 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.