Tracie Wagner

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

05722 Issued in MD

Practice address

6451 N Charles St
Baltimore, MD 21212-1010

Phone

(877) 407-3422

NPI assigned

Nov 7, 2017

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 MD

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Accessible Speech Therapy, LLCGroup PAC ID 7214344282, 2 clinicians

Fox Rehab SLP MD LLCGroup PAC ID 4183864226, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Accessible Speech Therapy, LLC

  • Speech-Language Pathologist
  • Baltimore, MD
  • NPI 1689267064
  Medicare reassignment Care Compare group NPD
• Fox Rehab SLP MD LLC

  • Speech-Language Pathologist
  • Timonium, MD
  • NPI 1306184924
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1510012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510012800000",
    "number": "1851804363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 CARNEGIE PLZ",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080031000",
            "telephone_number": "877-407-3422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6451 N CHARLES ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212121010",
            "telephone_number": "877-407-3422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "TRACIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-07",
        "last_updated": "2017-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": "05722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michele Lynn Wagner, LGSW
• Norma Jean Wagner, RD, LDN
• Pablo Wagner, M.D.
• Phillip Wagner, MD
• Sheryl M Wagner, PHARM.D.
• Mark Dean Waguespack, MD
• Maybel Josephine Wahab, CNM
• Barbara Wahl Wahl, RN
• Nicole L Waihman
• Namiyah Wailes

• Speech-Language Pathologist in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Speech-Language Pathologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2017; 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.