Active NPI
Landi Gayle Wagner, BS
- Counselor
- Lamar, CO
National Provider Identifier
1316112006
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 100 Kendall Dr
Lamar, CO 81052 - Phone
- (719) 336-7501
- Fax
- (719) 336-7453
- NPI assigned
- Apr 24, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
100 Kendall Dr
Lamar, CO 81052
Mailing address
711 Barnes Ave
La Junta, CO 81050
Phone (719) 384-5446
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Bachelor of Science
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349654400000",
"number": "1316112006",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "711 BARNES AVE",
"city": "LA JUNTA",
"state": "CO",
"postal_code": "81050",
"telephone_number": "719-384-5446",
"fax_number": "719-384-5672"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 KENDALL DR",
"city": "LAMAR",
"state": "CO",
"postal_code": "81052",
"telephone_number": "719-336-7501",
"fax_number": "719-336-7453"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGNER",
"first_name": "LANDI",
"middle_name": "GAYLE",
"credential": "BS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-24",
"last_updated": "2012-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lamar, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 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.