James Wagner, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

3318 Issued in MN

Practice address

2324 University Ave W Ste 100
Saint Paul, MN 55114-8759

Phone

(651) 641-1009

Fax

(651) 789-5677

NPI assigned

Oct 11, 2017

Last updated

Aug 29, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Midtown Management LTD

  dba Northland Therapy Center

  • Psychologist
  • Saint Paul, MN
  • NPI 1568585420
  Medicare reassignment NPD Authorized official
• Birch Counseling, PLLC.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Minnetonka, MN
  • NPI 1598186330
  NPD (past)

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

{
    "created_epoch": "1507680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598659200000",
    "number": "1245740687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 7TH ST SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554141112",
            "telephone_number": "612-824-7748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2324 UNIVERSITY AVE W STE 100",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551148759",
            "telephone_number": "651-641-1009",
            "fax_number": "651-789-5677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "JAMES",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-11",
        "last_updated": "2020-08-29",
        "certification_date": "2020-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "3318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kendra Lynn Wagener, LICSW
• Corilyn Ashley Wagner
• Cynthia L Wagner, OTR/L
• Emily Ashley Wagner, MD
• Gerhardt Stefan Wagner, MD
• Jonathan Eric Wagner, LPCC
• Keeli Nicole Wagner, LICSW
• Linnae Merith Wagner, PT
• Maria Joseph Wagner, RDCS
• Michael Hilmar Wagner, R.D., L.D.

• Marriage & Family Therapist in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Marriage & Family Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.