Kayce Leah Wagner, MS, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

1484 Issued in SC

Practice address

800 University Way
Spartanburg, SC 29303-4932

Phone

(864) 503-5046

NPI assigned

Jun 23, 2013

Last updated

Jul 21, 2022By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1371945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1639518624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 E LEE RD",
            "city": "TAYLORS",
            "state": "SC",
            "postal_code": "296873260",
            "telephone_number": "716-969-0906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 UNIVERSITY WAY",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293034932",
            "telephone_number": "864-503-5046"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30 Rimmon Trl",
            "address_purpose": "LOCATION",
            "city": "Travelers Rest",
            "state": "SC",
            "postal_code": "296901869",
            "country_code": "US",
            "telephone_number": "716-969-0906",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "KAYCE",
        "middle_name": "LEAH",
        "name_prefix": "Ms.",
        "credential": "MS, ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-23",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "SC",
            "license": "1484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Katherine Wade, LMFT-A
• Thomas Wager II, PT, DPT
• Brian Wagner
• Chad Richard Wagner, D.C.
• Jeffrey M Wagner, MD
• Lindsay Anne Wagner, RN
• Katelyn Wagoner
• Daniel Lee Wagstaff, M.D.
• Rebecca Leigh Wagstaff, M.D.
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-1281)

• Athletic Trainer in Spartanburg, SC
• Providers in Spartanburg, SC by specialty
• Athletic Trainer in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.