Active NPI
Shinnayha Nicole Wagner
- Occupational Therapy Assistant
- Phoenix, AZ
National Provider Identifier
1649771445
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 7346
- Practice address
- 13220 S 48TH St Apt 1112
Phoenix, AZ 85044-5013 - Phone
- (928) 551-1020
- NPI assigned
- Feb 27, 2018
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 7346 | AZ | Primary |
Addresses
Primary practice location
13220 S 48TH St Apt 1112
Phoenix, AZ 85044-5013
Mailing address
13220 S 48TH St Apt 1112
Phoenix, AZ 85044-5013
Phone (928) 551-1020
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7346 | AZ | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519689600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529107200000",
"number": "1649771445",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13220 S 48TH ST APT 1112",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850445013",
"telephone_number": "928-551-1020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13220 S 48TH ST APT 1112",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850445013",
"telephone_number": "928-551-1020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGNER",
"first_name": "SHINNAYHA",
"middle_name": "NICOLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-02-27",
"last_updated": "2018-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "AZ",
"license": "7346",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.