Scott Charles Wagner

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

1840 Capitol St
Vallejo, CA 94590-5721

Phone

(510) 459-9894

NPI assigned

Mar 11, 2025

Sex

Male

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

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

{
    "created_epoch": "1741651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741651200000",
    "number": "1548069669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2751 NAPA VALLEY CORPORATE DR",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "945586216",
            "telephone_number": "510-459-9894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 CAPITOL ST",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945905721",
            "telephone_number": "510-459-9894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "SCOTT",
        "middle_name": "CHARLES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-03-11",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christianne Wa, MD
• Katherine Ann Wade, RN, NP
• Kristina Holman Wadley, CRNA
• Denisha Wagner-Perry
• Phillip Leroy Wagner, MD
• Margaret Mary Wahl, RN,
• George E. Wakerlin Jr., MD
• Walgreen Co
• Walgreen Co
• Carrielee Nicole Walker

• All providers in Vallejo, CA
• Community Health Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2025; 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.