Cara Danielle Wagstaff, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

218047 Issued in TX

Practice address

5947 FM 2864 Lot 3
Nacogdoches, TX 75965-8929

Phone

(936) 553-9129

NPI assigned

Feb 27, 2024

Last updated

Feb 27, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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": "1708992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708992000000",
    "number": "1477319465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5947 FM 2864 LOT 3",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759658929",
            "telephone_number": "936-553-9129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5947 FM 2864 LOT 3",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759658929",
            "telephone_number": "936-553-9129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGSTAFF",
        "first_name": "CARA",
        "middle_name": "DANIELLE",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-27",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TX",
            "license": "218047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kalisha Wade, CCC SLP
• Ladedra Wade
• Wagoner Health Clinic, PLLC (Wagoner Family Health Clinic)
• James Lucas Wagoner, MSN, APRN, FNP-C
• Rebekah Marie Wagoner, APRN, FNP-C
• Wal-Mart Stores Texas LLC (Walmart Pharmacy 10-4674)
• Wal-Mart Stores Texas LLC (Walmart Pharmacy 10-0163)
• Wal-Mart Stores Texas, LP (Vision Center 30-0163)
• Walgreen Co (Walgreens #09400)
• Latoya Walker, MA

• Occupational Therapy Assistant in Nacogdoches, TX
• Providers in Nacogdoches, TX by specialty
• Occupational Therapy Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2024; 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.