Angela Waggener, M.S. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

106854 Issued in TX

Practice address

101 Watermere Dr
Southlake, TX 76092-8116

Phone

(817) 431-8668

NPI assigned

Jan 20, 2016

Sex

Female

Sole proprietor

Yes

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 TX

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Healthpro Heritage Rehab & Fitness, LLC

  • Physical Therapist
  • Georgetown, TX
  • NPI 1952531154

  Speech-Language Pathologist

  Medicare reassignment NPD
• Healthpro Heritage Rehab & Fitness, LLC

  • Physical Therapist
  • Independence, MO
  • NPI 1871072462

  Speech-Language Pathologist

  NPD

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

{
    "created_epoch": "1453248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453248000000",
    "number": "1760849830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5021 MARINEWAY DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761351809",
            "telephone_number": "405-555-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 WATERMERE DR",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760928116",
            "telephone_number": "817-431-8668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGGENER",
        "first_name": "ANGELA",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-20",
        "last_updated": "2016-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "106854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shailesh C Vora, M. D.
• Vra, Inc (ValMed)
• Avni Vyas, PH.D
• Danielle Wade
• Hannah Faith Wadsworth
• Grace M Wainhouse, AUD
• Haseeb Wajid, PHARMD
• Michael James Waldron, M.D.
• Walgreen Co (Walgreens #05919)
• Christianna D Walker

• Speech-Language Pathologist in Southlake, TX
• Providers in Southlake, TX by specialty
• Speech-Language Pathologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.