Nautica Wager

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP-6332 Issued in ID

Practice address

1835 N Wildwood St
Boise, ID 83713-5146

Phone

(877) 200-8152

NPI assigned

Mar 25, 2024

Sex

Female

Sole proprietor

No

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

State licenses

Practice roles

Locations

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.

• Kidscare Home Health of Idaho, LLC

  • Nursing Care Agency
  • Boise, ID
  • NPI 1144055765
  NPD
• Kidscare Home Health of Idaho, LLC

  • Home Health Agency
  • Boise, ID
  • NPI 1265902332
  NPD (past)

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

{
    "created_epoch": "1711324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711324800000",
    "number": "1699525345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4164 S FEDERAL WAY APT Q103",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837165572",
            "telephone_number": "850-226-2127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1835 N WILDWOOD ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837135146",
            "telephone_number": "877-200-8152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGER",
        "first_name": "NAUTICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-25",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ID",
            "license": "SLP-6332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karla Marie Wade, M.A., L.P.C.
• Katelyn Cramer Wade, PA, RD
• Samantha Wade, RD
• Anant Wadhwa
• Thomas Gill Wadsworth, PHARM.D.
• Jill Shelton Wagers, DMD
• Jocelyn M Waggoner, MD
• April Amber Wagner, PHARMD
• Brandon Mark Wagner, DDS
• Edward C Wagner, DMD

• Speech-Language Pathologist in Boise, ID
• Providers in Boise, ID by specialty
• Speech-Language Pathologist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2024; 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.