Katherine Ann Wagner, RN, FNP-BC, NP-C

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

21313 Issued in CA

Practice address

2951 Fulton Ave
Sacramento, CA 95821-4909

Phone

(916) 486-7555

Fax

(916) 486-7557

NPI assigned

Nov 9, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/19797/brand/1/csg/1/fhir/r4

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.

• All Inclusive Medical Services, Inc

  • Internal Medicine Physician
  • Carmichael, CA
  • NPI 1518369891
  Medicare reassignment NPD
• Siskiyou Hospital, Inc.

  • Critical Access Hospital
  • Yreka, CA
  • NPI 1093892275
  Medicare reassignment NPD
• Janak Kumar Mehtani, M.D.

  • Psychiatry Physician
  • Sacramento, CA
  • NPI 1477581106
  Medicare reassignment
• Capital Medical Extended Care

  • Skilled Nursing Facility
  • Sacramento, CA
  • NPI 1295131092
  NPD (past)
• Chandan DS Cheema MD Inc

  • Internal Medicine Physician
  • Fair Oaks, CA
  • NPI 1598965667
  NPD (past)
• On Demand Primary Care & Nursing, Inc

  • Primary Care Nurse Practitioner
  • Rocklin, CA
  • NPI 1417235532
  NPD (past)

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

{
    "created_epoch": "1320796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394668800000",
    "number": "1538446117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2951 FULTON AVE",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958214909",
            "telephone_number": "916-486-7555",
            "fax_number": "916-486-7557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2951 FULTON AVE",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958214909",
            "telephone_number": "916-486-7555",
            "fax_number": "916-486-7557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "KATHERINE",
        "middle_name": "ANN",
        "credential": "RN, FNP-BC, NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-09",
        "last_updated": "2014-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "21313",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "21313",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "21313",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI/MEDI, COMMERCIAL INSURANCE  CONTRACTED WITH CLINIC",
            "identifier": "1538446117",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lois Elaine Waetjen, M.D.
• Jose Rafael Doroy Wagas
• Sonali Raman Wagh, DDS
• Amanda Wagner
• Brian Lee Wagner, M.D.
• Leslie Wagner, RN
• Linda Wagner
• Maresha Wagner
• Marilou Wagner, CRNA
• Matthew Wagner

• Psychiatric/Mental Health Nurse Practitioner in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.