Active NPI
Cheryl L. Wagner, ARNP
- Family Nurse Practitioner
- Seattle, WA
National Provider Identifier
1609927409
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- AP30001369
- Practice address
- 200 15TH Ave E
Seattle, WA 98112-5260 - Phone
- (206) 326-3000
- NPI assigned
- Jan 16, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | RN00080676 | WA | |
| Family Nurse Practitioner | 363LF0000X | AP30001369 | WA | Primary |
Addresses
Primary practice location
200 15TH Ave E
Seattle, WA 98112-5260
Mailing address
PO Box 34584
Seattle, WA 98124-1584
Phone (509) 241-7349
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9608373 | Medicaid | WA |
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
- Credentials
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1192665600000",
"number": "1609927409",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 34584",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981241584",
"telephone_number": "509-241-7349",
"fax_number": "509-241-7628"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 15TH AVE E",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981125260",
"telephone_number": "206-326-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGNER",
"first_name": "CHERYL",
"middle_name": "L.",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-16",
"last_updated": "2007-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "WA",
"license": "RN00080676",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "WA",
"license": "AP30001369",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9608373",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 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.