Nancy Michele Wagner, ARNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP60677444 Issued in WA

Practice address

2105 112TH Ave NE Ste 201
Bellevue, WA 98004-2945

Phone

(425) 968-5948

NPI assigned

May 3, 2016

Last updated

Oct 17, 2019By 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 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jul 1, 2017 through Jul 1, 2027

Medicare enrollment (NPD)

Not enrolled

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

• Adagio Psychiatric Services

  • Psychiatry Physician
  • Bellevue, WA
  • NPI 1891325031
  NPD Authorized official
• Eastside Anxiety PLLC

  • Psychiatry Physician
  • Bellevue, WA
  • NPI 1063145332
  NPD Authorized official
• Eastside Play Therapy

  • Mental Health Counselor
  • Bellevue, WA
  • NPI 1922587328
  NPD (past)
• Lee Moore, Arnp, PLLC

  dba Better Mental Health & Wellness

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Baltimore, MD
  • NPI 1609374180

  Psychiatric/Mental Health

  NPD (past)

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

{
    "created_epoch": "1462233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571270400000",
    "number": "1326493891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2105 112TH AVE NE STE 201",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980042945",
            "telephone_number": "425-968-5948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 112TH AVE NE STE 201",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980042945",
            "telephone_number": "425-968-5948"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4205 148th Ave NE Ste 103",
            "address_purpose": "LOCATION",
            "city": "Bellevue",
            "state": "WA",
            "postal_code": "980077114",
            "country_code": "US",
            "telephone_number": "425-968-5948",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "NANCY",
        "middle_name": "MICHELE",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-03",
        "last_updated": "2019-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP60677444",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "121853",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN60657515",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Washington Vu
• Blake Wachi, M.D.
• Neil H. Waddington, M.D.
• Chandur PK Wadhwani, DDS, MSD
• Evonne Wagner - Sears, SOTP
• Randee Michelle Wagner, M.ED, BCBA
• Cailen Ahmed Wahan
• Marianne Hanna Wahba, PA-C
• Eric Thomas Wahl, DPT
• Wahu Jones LCC Dba Serenity Psychiatry & Wellness

• Psychiatric/Mental Health Nurse Practitioner in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2019; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.