Sandra M Wagoner, OT

Primary specialty

Hand Occupational TherapistTaxonomy code 225XH1200X

License

0119000123 Issued in VA

Practice address

410 Albemarle SQ
Charlottesville, VA 22901-7400

Phone

(434) 817-4278

NPI assigned

Jan 11, 2007

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)

Enrolled

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292803200000",
    "number": "1518017797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1583",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229021583",
            "telephone_number": "434-654-7794",
            "fax_number": "434-654-7752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 ALBEMARLE SQ",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229017400",
            "telephone_number": "434-817-4278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGONER",
        "first_name": "SANDRA",
        "middle_name": "M",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-11",
        "last_updated": "2010-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "VA",
            "license": "0119000123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bruce Robert Wagner, CCC AUDIOLOGY
• Eric N Wagner
• Scott Brian Wagner, D.C.
• Brianna Wagoner
• Carolyn Bean Wagoner, D.D.S.
• Megan Marie Waguespack, MD
• Margaret Austin Wahle
• Michael Wakim
• Wal-Mart Stores East LP
• Wal-Mart Stores East, LP

• Hand Occupational Therapist in Charlottesville, VA
• Providers in Charlottesville, VA by specialty
• Hand Occupational Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2010; 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.