Shawn Carl Wagner

Primary specialty

Home Modifications ContractorTaxonomy code 171WH0202X

Practice address

2545 County Road 218
Clyde, OH 43410-9521

Phone

(419) 307-0529

NPI assigned

Apr 23, 2012

Last updated

Apr 23, 2012By the provider in NPPES

Sex

Male

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

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

{
    "created_epoch": "1335139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335139200000",
    "number": "1235496639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2545 COUNTY ROAD 218",
            "city": "CLYDE",
            "state": "OH",
            "postal_code": "434109521",
            "telephone_number": "419-307-0529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2545 COUNTY ROAD 218",
            "city": "CLYDE",
            "state": "OH",
            "postal_code": "434109521",
            "telephone_number": "419-307-0529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "SHAWN",
        "middle_name": "CARL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-23",
        "last_updated": "2012-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171WH0202X",
            "taxonomy_group": "",
            "desc": "Contractor, Home Modifications",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carrie Stuck, LCDCIII
• Heather Christine Swander, LPN
• Theresa Carolyn Tester
• Jennifer L Van Hattem, LPN
• Amanda Lynn Wagner
• Nicole Marie Wetoskey, PHARM. D
• Jodi Lynn Witt
• Women to Women Midwifery Care
• Work Horizons, LTD.
• Jewelene Workman, COTA/L

• Home Modifications Contractor in Clyde, OH
• Providers in Clyde, OH by specialty
• Home Modifications Contractor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2012; 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.