Samantha Ann Wagner, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY11685 Issued in FL

Practice address

20747 Sterlington Dr
Land O Lakes, FL 34638-4317

Phone

(813) 815-2947

Fax

(813) 948-0094

NPI assigned

Oct 26, 2022

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

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

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.

• Samantha a. Wagner, PHD, LLC

  • Psychologist
  • Land O Lakes, FL
  • NPI 1548045131
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1666742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666742400000",
    "number": "1457078735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20747 STERLINGTON DR",
            "city": "LAND O LAKES",
            "state": "FL",
            "postal_code": "346384317",
            "telephone_number": "813-815-2947",
            "fax_number": "813-948-0094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20747 STERLINGTON DR",
            "city": "LAND O LAKES",
            "state": "FL",
            "postal_code": "346384317",
            "telephone_number": "813-815-2947",
            "fax_number": "813-948-0094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "SAMANTHA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-26",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY11685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Anthony Villapiano, LCSW
• Virtual Rehab RX, LLC
• Vista Behavioral Health, PLLC
• Vitaly Levintov
• Ladislav Volicer, M.D.
• Walgreen Co
• Walgreen Co
• Ellen Marie Ward, M.S. CCC-SLP
• Mary Marie Wasinger
• Cheryl Waterbury

• Clinical Psychologist in Land O Lakes, FL
• Providers in Land O Lakes, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.