Individual provider Active NPI

Sandra Wagner

  • Speech-Language Pathologist
  • Sun Prairie, WI
National Provider Identifier
1407752454
Registry record updated Oct 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
1435 N Thompson Rd
Sun Prairie, WI 53590-6108
Phone
(608) 478-5100
NPI assigned
Oct 16, 2026
Last updated
Oct 16, 2026By the provider in NPPES
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X WI Primary

Addresses

Primary practice location

1435 N Thompson Rd
Sun Prairie, WI 53590-6108

Mailing address

6693 Wendell Way
Deforest, WI 53532-2700
Phone (262) 483-4269

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1792108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792108800000",
    "number": "1407752454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6693 WENDELL WAY",
            "city": "DEFOREST",
            "state": "WI",
            "postal_code": "535322700",
            "telephone_number": "262-483-4269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1435 N THOMPSON RD",
            "city": "SUN PRAIRIE",
            "state": "WI",
            "postal_code": "535906108",
            "telephone_number": "608-478-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "SANDRA",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2026-10-16",
        "last_updated": "2026-10-16",
        "certification_date": "2026-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sun Prairie, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.