Active NPI
Anna Grace Wagoner
- Speech-Language Pathologist
- Mount Airy, NC
National Provider Identifier
1700708864
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 30003090
- Practice address
- 351 Riverside Dr
Mount Airy, NC 27030-3850 - Phone
- (336) 786-8355
- NPI assigned
- Jul 29, 2026
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 30003090 | NC | Primary |
Addresses
Primary practice location
351 Riverside Dr
Mount Airy, NC 27030-3850
Mailing address
215 Oak Hill Dr
Mount Airy, NC 27030-7484
Phone (336) 755-9033
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1785283200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785283200000",
"number": "1700708864",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "215 OAK HILL DR",
"city": "MOUNT AIRY",
"state": "NC",
"postal_code": "270307484",
"telephone_number": "336-755-9033"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "351 RIVERSIDE DR",
"city": "MOUNT AIRY",
"state": "NC",
"postal_code": "270303850",
"telephone_number": "336-786-8355"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGONER",
"first_name": "ANNA",
"middle_name": "GRACE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2026-07-29",
"last_updated": "2026-07-29",
"certification_date": "2026-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NC",
"license": "30003090",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Mount Airy, NC
- Casey A Vedder, PT
- Marvin Clark Vice, D.O.
- Josue Alejandro Villegas-Silva
- Vitamind Counseling PLLC
- Cortland Caroline Voelkel, PA-C
- Christopher Chad Wagoner
- Wake Forest University Baptist Medical Center Community Physicians
- Wake Forest University Health Sciences
- Wal-Mart Stores East LP
- Wal-Mart Stores East, LP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.