Kandy Kay Wagner, M.T.

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

332924-00 Issued in MI

Practice address

21526 Harper Ave
St. Clair Shores, MI 48080

Phone

(586) 242-5729

NPI assigned

Jun 8, 2010

Last updated

Jun 8, 2010By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Medical Technician

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

• Exodus Hair & Nail Studio LLC

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  • Saint Clair Shores, MI
  • NPI 1114468428
  NPD (past) Authorized official
• In Your Home Senior Assistance LLC

  • In Home Supportive Care Agency
  • Chesterfield, MI
  • NPI 1629562665
  NPD (past) Authorized official
• Serenity Now

  • Massage Therapist
  • Harrison TWP, MI
  • NPI 1689967226
  NPD (past) Authorized official

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

{
    "created_epoch": "1275955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275955200000",
    "number": "1306166723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38815 LAKESHORE DRIVE",
            "city": "HARRISON TOWNSHIP",
            "state": "MI",
            "postal_code": "48045",
            "telephone_number": "586-242-5729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21526 HARPER AVE",
            "city": "ST. CLAIR SHORES",
            "state": "MI",
            "postal_code": "48080",
            "telephone_number": "586-242-5729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "KANDY",
        "middle_name": "KAY",
        "credential": "M.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-08",
        "last_updated": "2010-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "MI",
            "license": "332924-00",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Van Chau Hong Vo, M.D.
• John Vollmer, PA-C
• William James Vornberger, MD
• Lamthy Quoc Vu, RPH
• Judith Wagner
• Paul Steven Wainess, DDS
• Jehan Wakeem, DDS
• Walgreen Co (Walgreens #01610)
• Walgreen Co (Walgreens #04308)
• Walgreen Co (Walgreens #07787)

• Massage Therapist in Saint Clair Shores, MI
• Providers in Saint Clair Shores, MI by specialty
• Massage Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2010; 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.