Patricia Wagner, OT

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

OT001966 Issued in OH

Practice address

11230 Cornell Park Dr
Blue Ash, OH 45242-1825

Phone

(513) 880-6800

NPI assigned

Jan 11, 2008

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Practice roles

Locations

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.

• Big Blue Canopy LLC

  • Physical Therapist
  • Blue Ash, OH
  • NPI 1548820772
  Medicare reassignment NPD
• Abc Pediatric Therapy LLC

  dba ABC Pediatric Therapy Network

  • Physical Therapist
  • West Chester, OH
  • NPI 1134152861
  NPD (past)

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

{
    "created_epoch": "1200009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586304000000",
    "number": "1225214083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11230 CORNELL PARK DR",
            "city": "BLUE ASH",
            "state": "OH",
            "postal_code": "452421825",
            "telephone_number": "513-880-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11230 CORNELL PARK DR",
            "city": "BLUE ASH",
            "state": "OH",
            "postal_code": "452421825",
            "telephone_number": "513-880-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "PATRICIA",
        "credential": "OT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-11",
        "last_updated": "2020-04-08",
        "certification_date": "2020-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "OH",
            "license": "OT001966",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2187155",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy N Vucurevich
• Michelle Waddell, FNP-C
• Salma J Wadud
• Melanee Lynn Wagener
• Hali R Wagner
• Salamata Waiga, LISW, LCSW
• Deborah Walbright
• Merilee Stienecker Wale, MSW, LISW
• Walgreen Co (Walgreens #02697)
• Shakela Walker

• Pediatric Occupational Therapist in Blue Ash, OH
• Providers in Blue Ash, OH by specialty
• Pediatric Occupational Therapist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.