Individual provider Active NPI

Amber Dawn Wagner

  • Personal Care Attendant
  • Reedsville, WV
National Provider Identifier
1770179640
Registry record updated Dec 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Personal Care AttendantTaxonomy code 3747P1801X
Practice address
865 Indian Rock Rd
Reedsville, WV 26547-7117
Phone
(304) 621-2192
NPI assigned
Dec 15, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Care Attendant 3747P1801X Primary

Addresses

Primary practice location

865 Indian Rock Rd
Reedsville, WV 26547-7117

Mailing address

865 Indian Rock Rd
Reedsville, WV 26547-7117
Phone (304) 621-2192

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": "1607990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607990400000",
    "number": "1770179640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "865 INDIAN ROCK RD",
            "city": "REEDSVILLE",
            "state": "WV",
            "postal_code": "265477117",
            "telephone_number": "304-621-2192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "865 INDIAN ROCK RD",
            "city": "REEDSVILLE",
            "state": "WV",
            "postal_code": "265477117",
            "telephone_number": "304-621-2192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "AMBER",
        "middle_name": "DAWN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-15",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reedsville, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2020; 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.