Active NPI
Carlie Wager, DDS
- Dentist
- Woodstock, GA
National Provider Identifier
1659756658
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN015042
- Practice address
- 12201 Highway 92
Woodstock, GA 30188-7140 - Phone
- (678) 202-4904
- Fax
- (678) 202-4197
- NPI assigned
- Jul 21, 2015
- Last updated
- Jul 21, 2015
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | DN015042 | GA | Primary |
Addresses
Primary practice location
12201 Highway 92
Woodstock, GA 30188-7140
Mailing address
12201 Highway 92
Woodstock, GA 30188-7140
Phone (678) 202-4904
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160722001936 | GA | Order and Referring Only - Other (Non-Physician) | 9032402474 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN015042 | GA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1437436800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1437436800000",
"number": "1659756658",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12201 HIGHWAY 92",
"city": "WOODSTOCK",
"state": "GA",
"postal_code": "301887140",
"telephone_number": "678-202-4904",
"fax_number": "678-202-4197"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12201 HIGHWAY 92",
"city": "WOODSTOCK",
"state": "GA",
"postal_code": "301887140",
"telephone_number": "678-202-4904",
"fax_number": "678-202-4197"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGER",
"first_name": "CARLIE",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-07-21",
"last_updated": "2015-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "GA",
"license": "DN015042",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodstock, GA
- Voices and Motion, Inc
- Amanda Naseef Volker, NP
- W Bruce Fink DDS PC
- Rhonda Rouse Wachsmuth, M.D.
- Alex Wade, PT, DPT
- Wal-Mart Stores East LP (Walmart Pharmacy 10-5275)
- Wal-Mart Stores East LP (Walmart Pharmacy 10-0575)
- Wal-Mart Stores East, LP (Vision Center 30-5275)
- Wal-Mart Stores Easts, LP.
- Harrison Tanner Waldron, RN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.