Caitlin E Wagner, AA

Primary specialty

Anesthesiologist AssistantTaxonomy code 367H00000X

License

2020029245 Issued in MO

Practice address

10010 Kennerly Rd
Saint Louis, MO 63128-2106

Phone

(636) 386-7222

NPI assigned

Aug 6, 2020

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

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Specialty

Anesthesiology Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

South County Anesthesia Associates LTDGroup PAC ID 4082510383, 81 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital South Hospital, Saint Louis, MO, CCN 260077

Medicare enrollment (NPD)

Enrolled

Credentials

Associate of Arts

State licenses

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.

• South County Anesthesia Associates, LTD.

  • Anesthesiology Physician
  • Saint Louis, MO
  • NPI 1821031659
  Medicare reassignment Care Compare group NPD
• South County Anesthesia Associates, LTD

  • Pain Clinic/Center
  • Wentzville, MO
  • NPI 1114290749
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mercy Hospital South

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1568481984
  Care Compare affiliation

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

{
    "created_epoch": "1596672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599177600000",
    "number": "1265042014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22407",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631260407",
            "telephone_number": "636-386-7222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10010 KENNERLY RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282106",
            "telephone_number": "636-386-7222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "CAITLIN",
        "middle_name": "E",
        "credential": "AA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-06",
        "last_updated": "2020-09-04",
        "certification_date": "2020-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "MO",
            "license": "2020029245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hallie Elyse Waggoner, PHARMD
• Bindu Wagle
• Lisa Wagner-Daegling, M.ED., PLPC
• Amanda Marie Wagner, FNP
• Austin Michael Wagner, ATC
• Carole Sue Wagner, O.T.R./L
• Corey Allen Wagner, MD
• Daniel Lee Wagner, MD
• Daniel R. Wagner, MD
• David Francis Wagner, RN

• Anesthesiologist Assistant in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Anesthesiologist Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.