Megan Theresa Wagner

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

22005964A Issued in IN

Practice address

6437 Rucker Rd
Suite D
Indianapolis, IN 46220-4885

Phone

(317) 405-9016

NPI assigned

Jan 23, 2009

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Megan Theresa Jablonowski Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Pediatric Specialty Associates, Inc

  • Early Intervention Provider Agency
  • Indianapolis, IN
  • NPI 1336212638

  Speech-Language Pathologist

  NPD (past)
• Pediatric Specialty Associates, Inc

  • Early Intervention Provider Agency
  • Indianapolis, IN
  • NPI 1346628492
  NPD (past)

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

{
    "created_epoch": "1232668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424304000000",
    "number": "1740428135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "564 STAFFORD DR",
            "city": "WESTFIELD",
            "state": "IN",
            "postal_code": "460745809",
            "telephone_number": "330-321-3999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6437 RUCKER RD",
            "address_2": "SUITE D",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462204885",
            "telephone_number": "317-405-9016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "MEGAN",
        "middle_name": "THERESA",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-23",
        "last_updated": "2015-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "46001920A",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22005964A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEGAN",
            "last_name": "JABLONOWSKI",
            "middle_name": "THERESA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jack Wagner
• Jeffrey David Wagner, MD
• John F Wagner, MD
• Karyn Elizabeth Wagner
• Keelie Madison Wagner, APRN, CPNP-PC
• Monica Wagner
• Patrick A Wagner, PHD
• Samantha Louise Wagner, M.D.
• Susan Elaine Wagner, DDS
• Whitney Wagner, NP-C

• Speech-Language Pathologist in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Speech-Language Pathologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2015; 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.