Active NPI
Stephanie Ellen Waggel, MD, MS
- Psychiatry Physician
- Herndon, VA
National Provider Identifier
1376954719
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 0101260311
- Practice address
- 2201 Cooperative Way Ste 600
Herndon, VA 20171-3005 - Phone
- (646) 776-0739
- Fax
- (703) 788-6867
- NPI assigned
- May 19, 2014
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 0101260311 | VA | Primary |
Addresses
Primary practice location
2201 Cooperative Way Ste 600
Herndon, VA 20171-3005
Mailing address
2201 Cooperative Way Ste 600
Herndon, VA 20171-3005
Phone (646) 776-0739
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
- Doctor of Medicine, Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101260311 | VA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1400457600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1508198400000",
"number": "1376954719",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2201 COOPERATIVE WAY STE 600",
"city": "HERNDON",
"state": "VA",
"postal_code": "201713005",
"telephone_number": "646-776-0739"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2201 COOPERATIVE WAY STE 600",
"city": "HERNDON",
"state": "VA",
"postal_code": "201713005",
"telephone_number": "646-776-0739",
"fax_number": "703-788-6867"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGGEL",
"first_name": "STEPHANIE",
"middle_name": "ELLEN",
"name_prefix": "Dr.",
"credential": "MD, MS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-05-19",
"last_updated": "2017-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "VA",
"license": "0101260311",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Herndon, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.