Timothy Wagoner

Primary specialty

School PsychologistTaxonomy code 103TS0200X

License

LSP.01201 Issued in OH

Practice address

3205 Park St
Grove City, OH 43123-3215

Phone

(614) 801-8800

NPI assigned

Oct 15, 2026

Last updated

Oct 15, 2026By the provider in NPPES

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

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

{
    "created_epoch": "1792022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792022400000",
    "number": "1548166846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3805 MARLANE DR",
            "city": "GROVE CITY",
            "state": "OH",
            "postal_code": "431239224",
            "telephone_number": "614-801-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3205 PARK ST",
            "city": "GROVE CITY",
            "state": "OH",
            "postal_code": "431233215",
            "telephone_number": "614-801-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGONER",
        "first_name": "TIMOTHY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-10-15",
        "last_updated": "2026-10-15",
        "certification_date": "2026-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "OH",
            "license": "LSP.01201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jamilah Renee Walker, MASSAGE THERAPY
• Douglas C Wallace, MD

• School Psychologist in Grove City, OH
• Providers in Grove City, OH by specialty
• School Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.