Julie Kristen Wagoner, AUD

Primary specialty

Audiologist-Hearing Aid FitterTaxonomy code 237600000X

License

2201001480 Issued in VA

Practice address

4660 Kenmore Ave Ste 409
Alexandria, VA 22304-1306

Phone

(703) 823-3336

Fax

(703) 823-4684

NPI assigned

Oct 20, 2011

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

Enrolled in DC

Enrollment records 1

Specialty

Qualified Audiologist

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Wagoner LLC

  • Audiologist-Hearing Aid Fitter
  • Alexandria, VA
  • NPI 1073163713

  DC

  Medicare reassignment Authorized official
• Cranberry Hearing and Balance Center, LLC

  • Audiologist-Hearing Aid Fitter
  • Cranberry Township, PA
  • NPI 1821260548

  DC

  Medicare reassignment

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

{
    "created_epoch": "1319068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1740565845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 ALBEMARLE DR",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223031305",
            "telephone_number": "703-851-5301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4660 KENMORE AVE STE 409",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223041306",
            "telephone_number": "703-823-3336",
            "fax_number": "703-823-4684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGONER",
        "first_name": "JULIE",
        "middle_name": "KRISTEN",
        "name_prefix": "Ms.",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-20",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "VA",
            "license": "2201001480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wagner Autism Growth LLC
• Kaitlynn Nicole Wagner, CCC-SLP
• Margaret Mary-Rose Wagner
• Megan Elizabeth Wagner, LBA, BCBA
• Wagoner LLC
• Shaquira Wakefield, LCSW-C
• Wal-Mart Stores East LP
• Wal-Mart Stores East LP
• Wal-Mart Stores East LP
• Wal-Mart Stores East, LP

• Audiologist-Hearing Aid Fitter in Alexandria, VA
• Providers in Alexandria, VA by specialty
• Audiologist-Hearing Aid Fitter in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.