Patricia Anne Wagner

Primary specialty

Orientation and Mobility Training Rehabilitation CounselorTaxonomy code 225CX0006X

License

3518 Issued in CO

Practice address

1401 Blackfoot TRL
Woodland Park, CO 80863-8304

Phone

(719) 686-1938

NPI assigned

Oct 27, 2014

Last updated

Oct 27, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Patricia Anne Husson Former name

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": "1414368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414368000000",
    "number": "1215332705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 BLACKFOOT TRL",
            "city": "WOODLAND PARK",
            "state": "CO",
            "postal_code": "808638304",
            "telephone_number": "719-686-1938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 BLACKFOOT TRL",
            "city": "WOODLAND PARK",
            "state": "CO",
            "postal_code": "808638304",
            "telephone_number": "719-686-1938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "PATRICIA",
        "middle_name": "ANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-27",
        "last_updated": "2014-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255R0406X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Rehabilitation, Blind",
            "state": "CO",
            "license": "3348",
            "primary": false
        },
        {
            "code": "225CX0006X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor, Orientation and Mobility Training Provider",
            "state": "CO",
            "license": "3518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PATRICIA",
            "last_name": "HUSSON",
            "middle_name": "ANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Rehabilitation Counselor in Woodland Park, CO
• Providers in Woodland Park, CO by specialty
• Rehabilitation Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2014; 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.