Active NPI
Gerald T Wagner, LSCSW #2286
- Clinical Social Worker
- Hays, KS
National Provider Identifier
1588729982
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LSCSW 2286
- Practice address
- 208 E 7TH
Hays, KS 67601-4199 - Phone
- (785) 628-2871
- Fax
- (785) 628-1248
- NPI assigned
- Dec 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LSCSW 2286 | KS | Primary |
Addresses
Primary practice location
208 E 7TH
Hays, KS 67601-4199
Mailing address
2022 Yocemento Ave
Hays, KS 67601-9678
Phone (785) 628-3726
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 069685 | Other | KS | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2286 | KS | MD | Professional Counselor |
| LSCSW 2286 | KS | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167091200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1588729982",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2022 YOCEMENTO AVE",
"city": "HAYS",
"state": "KS",
"postal_code": "676019678",
"telephone_number": "785-628-3726"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "208 E 7TH",
"city": "HAYS",
"state": "KS",
"postal_code": "676014199",
"telephone_number": "785-628-2871",
"fax_number": "785-628-1248"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGNER",
"first_name": "GERALD",
"middle_name": "T",
"credential": "LSCSW #2286",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "KS",
"license": "LSCSW 2286",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "069685",
"state": "KS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hays, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.