Lisa Louise Wagner, MA, CCC-A

Primary specialty

AudiologistTaxonomy code 231H00000X

License

1601000283 Issued in MI

Practice address

5040 Villa Linde Pkwy Ste a
Flint, MI 48532-3445

Phone

(810) 732-4250

Fax

(810) 732-0444

NPI assigned

Feb 11, 2008

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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.

• Mehmet C Agabigum MD PC

  • Otolaryngology/Facial Plastic Surgery Physician
  • Flint, MI
  • NPI 1972776052
  NPD

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

{
    "created_epoch": "1202688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582761600000",
    "number": "1578731725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5040 VILLA LINDE PKWY STE A",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323445",
            "telephone_number": "810-732-4250",
            "fax_number": "810-732-0444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5040 VILLA LINDE PKWY STE A",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323445",
            "telephone_number": "810-732-4250",
            "fax_number": "810-732-0444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "LISA",
        "middle_name": "LOUISE",
        "name_prefix": "Mrs.",
        "credential": "MA, CCC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-11",
        "last_updated": "2020-02-27",
        "certification_date": "2020-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MI",
            "license": "1601000283",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1578731725",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patricia Wagenhofer
• Zachery Wagester, BS, CMHP, QMHP, QIDP
• Britt Elisia Wagner, L.L.P.
• James W. Wagner, M.D.
• Jayme Gene Wagner
• Megan Wagner
• Shekinah Wagner
• Mallory Jean Waisanen, CCC-SLP
• Jamila Kesi Waits, BS,CAC-1
• Pranjali S Wakade, PA

• Audiologist in Flint, MI
• Providers in Flint, MI by specialty
• Audiologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.