Active NPI
Emilee Wagner
- Social Worker
- Osceola, IN
National Provider Identifier
1336812650
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 1415 Lincolnway W
Osceola, IN 46561-2062 - Phone
- (574) 299-3559
- NPI assigned
- Aug 2, 2021
- Last updated
- Aug 2, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | Primary |
Addresses
Primary practice location
1415 Lincolnway W
Osceola, IN 46561-2062
Mailing address
4312 Sail Dr
Mishawaka, IN 46544-9145
Phone (574) 299-3559
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1627862400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1627862400000",
"number": "1336812650",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4312 SAIL DR",
"city": "MISHAWAKA",
"state": "IN",
"postal_code": "465449145",
"telephone_number": "574-299-3559"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1415 LINCOLNWAY W",
"city": "OSCEOLA",
"state": "IN",
"postal_code": "465612062",
"telephone_number": "574-299-3559"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGNER",
"first_name": "EMILEE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-08-02",
"last_updated": "2021-08-02",
"certification_date": "2021-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Osceola, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.