Sarah H. Wagoner, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

100350 Issued in NC

Practice address

112 Medical Dr
Elizabeth City, NC 27909-3361

Phone

(252) 338-2151

Fax

(252) 338-2505

NPI assigned

Jan 15, 2007

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Albemarle Mental Health Center

  • Mental Health Counselor
  • Elizabeth City, NC
  • NPI 1013012400
  NPD (past)
• Ocean View Medical

  • Internal Medicine Physician
  • Nags Head, NC
  • NPI 1972641918
  NPD (past)

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

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208131200000",
    "number": "1235280538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 MEDICAL DR",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279093361",
            "telephone_number": "252-338-2151",
            "fax_number": "252-338-2505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 MEDICAL DR",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279093361",
            "telephone_number": "252-338-2151",
            "fax_number": "252-338-2505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGONER",
        "first_name": "SARAH",
        "middle_name": "H.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-15",
        "last_updated": "2008-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "100350",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7949645",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Velocity Urgent Care LLC
• Indya Verrastro, RBT
• Virginia Oncology Associates
• Dang-Khoa Vo, M.D., M.S.
• Kristen Vuyovich, CRNA
• Thomas Michael Waite, MSW, LCSW
• Wal-Mart Stores East LP
• Wal-Mart Stores East, LP
• Kara Waldrop, NP-C
• Walgreen Co

• All providers in Elizabeth City, NC
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2008; 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.