Tricia Francisco Wagner

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

91567 Issued in GA

Practice address

5008 Snapfinger Woods Dr
Decatur, GA 30035-4003

Phone

(770) 981-0210

NPI assigned

Mar 19, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/GGGACD/Endpoint/GGGACD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Healthy Kids R US PC

  • Pediatrics Physician
  • Dunwoody, GA
  • NPI 1811521867
  NPD (past)

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

{
    "created_epoch": "1552953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1427517283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5008 SNAPFINGER WOODS DR",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300354003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5008 SNAPFINGER WOODS DR",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300354003",
            "telephone_number": "770-981-0210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "TRICIA",
        "middle_name": "FRANCISCO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-19",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "91567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Wadleigh
• Monica Maria Wadley
• Peyton Waggener
• Amanda Kay Wagner, LCSW
• Matthew Wagner, LPC, CAADC
• Kristen Wagoner, LPC
• Abdul Wahab, PHD
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-3710)
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-3118)
• Wal-Mart Stores East, LP (Vision Center 30-3710)

• Pediatrics Physician in Decatur, GA
• Providers in Decatur, GA by specialty
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2023; 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.