Rebecca D Waegli, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

933 Issued in NE

Practice address

4501 S 70TH St
Suite 110
Lincoln, NE 68516-4282

Phone

(402) 489-3834

Fax

(402) 489-5049

NPI assigned

Jun 23, 2006

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

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

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.

• Lincoln Pediatric Group LLC

  • Pediatrics Physician
  • Lincoln, NE
  • NPI 1083640130
  NPD (past)
• Lincoln Pediatric Group LLC

  • Pediatrics Physician
  • Lincoln, NE
  • NPI 1508389610
  NPD (past)

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193011200000",
    "number": "1861428047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4501 S 70TH ST",
            "address_2": "SUITE 110",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685164282",
            "telephone_number": "402-489-3834",
            "fax_number": "402-489-5049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 S 70TH ST",
            "address_2": "SUITE 110",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685164282",
            "telephone_number": "402-489-3834",
            "fax_number": "402-489-5049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAEGLI",
        "first_name": "REBECCA",
        "middle_name": "D",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-23",
        "last_updated": "2007-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "933",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47049487112",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "36004",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "37320",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fallon Lenae Wade
• Misty Wade
• Shawn Alan Wade, MD
• Hannah Wadiso
• Muhammedamin Sado Wado, RN
• Stacy Waegli
• Theartis Wafer
• Gloria Wafula
• Katelyn Mae Wagaman
• Weaam A Wagealla

• Physician Assistant in Lincoln, NE
• Providers in Lincoln, NE by specialty
• Physician Assistant in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2007; 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.