Lenie Wagoner

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

806246 Issued in NY

Practice address

2399 County Route 12
Central Square, NY 13036-2347

Phone

(315) 741-6331

NPI assigned

Mar 15, 2021

Last updated

Mar 15, 2021By 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

State licenses

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

{
    "created_epoch": "1615766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615766400000",
    "number": "1376128991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2399 COUNTY ROUTE 12",
            "city": "CENTRAL SQUARE",
            "state": "NY",
            "postal_code": "130362347",
            "telephone_number": "315-741-6331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2399 COUNTY ROUTE 12",
            "city": "CENTRAL SQUARE",
            "state": "NY",
            "postal_code": "130362347",
            "telephone_number": "315-741-6331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGONER",
        "first_name": "LENIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-15",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "806246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valerie Meyers NP Adult Health PLLC
• Andrew Robert Vanmarter, PHARMD
• Kathleen Ann Ventura, RPH
• Village Dental Group of Central Square
• Vista Eyecare, LLC
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-2911)
• Wal-Mart Stores East, LP (Vision Center 30-2911)
• Walgreen Co (Walgreens #19814)
• Michael Wallon
• Daniel Patrick Walsh, DC

• Registered Nurse in Central Square, NY
• Providers in Central Square, NY by specialty
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 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.

Verify at the official NPI Registry.