Mary Anastasia Wagner

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

28229728A Issued in IN

Practice address

6460 Harrison Ave
Cincinnati, OH 45247-7957

Phone

(513) 941-4999

Fax

(513) 694-0168

NPI assigned

May 1, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Sunrise Treatment Center, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • West Union, OH
  • NPI 1215659412
  NPD (past)
• Sunrise Treatment Center, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Cincinnati, OH
  • NPI 1427729474
  NPD (past)
• Sunrise Treatment Center, LLC

  • Adult Mental Health Clinic/Center
  • Cincinnati, OH
  • NPI 1558844910
  NPD (past)
• Sunrise Treatment Center, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Cincinnati, OH
  • NPI 1992043053
  NPD (past)

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

{
    "created_epoch": "1493596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1558896233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6460 HARRISON AVE STE 200",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452477958",
            "telephone_number": "513-941-4999",
            "fax_number": "513-694-0168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6460 HARRISON AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452477957",
            "telephone_number": "513-941-4999",
            "fax_number": "513-694-0168"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1435 Cincinnati St",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454174614",
            "country_code": "US",
            "telephone_number": "513-941-4999",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Highview Blvd",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432076023",
            "country_code": "US",
            "telephone_number": "513-941-4999",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1718 Central Pkwy",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452142355",
            "country_code": "US",
            "telephone_number": "513-941-4999",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7075 Industrial Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "Florence",
            "state": "KY",
            "postal_code": "410423053",
            "country_code": "US",
            "telephone_number": "513-941-4999",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1421 Parker Ct",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "OH",
            "postal_code": "455042855",
            "country_code": "US",
            "telephone_number": "513-941-4999",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1130 Garbry Rd",
            "address_purpose": "LOCATION",
            "city": "Piqua",
            "state": "OH",
            "postal_code": "453568217",
            "country_code": "US",
            "telephone_number": "513-941-4999",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "247 Cic Blvd",
            "address_purpose": "LOCATION",
            "city": "West Union",
            "state": "OH",
            "postal_code": "456937512",
            "country_code": "US",
            "telephone_number": "513-941-4999",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1907 11th St",
            "address_purpose": "LOCATION",
            "city": "Portsmouth",
            "state": "OH",
            "postal_code": "456624531",
            "country_code": "US",
            "telephone_number": "513-941-4999",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "160 N Breiel Blvd",
            "address_purpose": "LOCATION",
            "city": "Middletown",
            "state": "OH",
            "postal_code": "450423806",
            "country_code": "US",
            "telephone_number": "513-941-4999",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "680 Northland Blvd",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452403248",
            "country_code": "US",
            "telephone_number": "513-941-4999",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "25 Whitney Dr Ste 122",
            "address_purpose": "LOCATION",
            "city": "Milford",
            "state": "OH",
            "postal_code": "451508400",
            "country_code": "US",
            "telephone_number": "513-941-4999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "MARY",
        "middle_name": "ANASTASIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-01",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28229728A",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN.437689",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0243160",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Lynn Wagner, R.N.
• Jessica E Wagner
• John J Wagner, PSY.D
• Leah Elizabeth Wagner, MS, RD, LD
• Madeline Michelle Wagner
• Nathaniel Wagner
• Robert J Wagner
• Ryan Wagner, PSYD.
• Kathleen A Wagoner
• Lauren Wahba, LISW

• Registered Nurse in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• Registered Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 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.