Kimberly Sue Waggy, MA;EDS

Primary specialty

School PsychologistTaxonomy code 103TS0200X

License

1304 Issued in WV

Practice address

408 Eb Saunders Way
Clarksburg, WV 26301

Phone

(304) 624-6554

Fax

(304) 624-5223

NPI assigned

Oct 7, 2008

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Harrison County Board of Education

  • Local Education Agency (LEA)
  • Clarksburg, WV
  • NPI 1164691044
  NPD (past)
• Harrison County Board of Education

  • Local Education Agency (LEA)
  • Clarksburg, WV
  • NPI 1720264377
  NPD (past)

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

{
    "created_epoch": "1223337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223337600000",
    "number": "1588815732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1370",
            "city": "CLARKSBURG",
            "state": "WV",
            "postal_code": "263021370",
            "telephone_number": "304-624-6554",
            "fax_number": "304-624-5223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 EB SAUNDERS WAY",
            "city": "CLARKSBURG",
            "state": "WV",
            "postal_code": "26301",
            "telephone_number": "304-624-6554",
            "fax_number": "304-624-5223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGGY",
        "first_name": "KIMBERLY",
        "middle_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "MA;EDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-07",
        "last_updated": "2008-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "WV",
            "license": "1304",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810013188",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Beatrice Viglianco
• Madeline Viglianco
• Thomas Vincent
• Angelique Ferrer Vitug, MD
• Tekisha Dehaven Waddell
• Angela D Wagner, LICSW
• Cristina Suzanne Wagoner, REGISTERED NURSE
• Ruth Wagoner
• Elizabeth Lague Wakim, D.D.S.
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-1544)

• School Psychologist in Clarksburg, WV
• Providers in Clarksburg, WV by specialty
• School Psychologist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2008; 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.