Berneeta L Wagoner, LISW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

00391 Issued in IA

Practice address

215 E Washington St
Clarinda, IA 51632-1625

Phone

(712) 542-3501

Fax

(712) 542-4725

NPI assigned

Oct 11, 2006

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

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in IA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1976

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Southwest Iowa Families IncGroup PAC ID 7315840428, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Southwest Iowa Families Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Clarinda, IA
  • NPI 1689762882
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197936000000",
    "number": "1699863894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 E WASHINGTON ST",
            "city": "CLARINDA",
            "state": "IA",
            "postal_code": "516321625",
            "telephone_number": "712-542-3501",
            "fax_number": "712-542-4725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 E WASHINGTON ST",
            "city": "CLARINDA",
            "state": "IA",
            "postal_code": "516321625",
            "telephone_number": "712-542-3501",
            "fax_number": "712-542-4725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGONER",
        "first_name": "BERNEETA",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2007-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IA",
            "license": "00391",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6571310",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IOWA MEDICAID ENTERPRISE",
            "identifier": "0427013",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "7320",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "129079",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK",
            "identifier": "58316",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Urology Center, PC
• Brittany Morgan Van Fosson, LMSW
• Courtney Jalene Vestal, LMSW
• Sara Jo Volkmar, B.A.
• Andrew James Voss
• Angela Renee Wallick, LMSW
• Ashleigh Nicole Waltz
• Waubonsie Mental Health Center Inc
• Julie Weiss, PT
• Wendy McCoy PC

• Social Worker in Clarinda, IA
• Providers in Clarinda, IA by specialty
• Social Worker in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.