Jessica Shirley Wagoner, MS/OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

P142944 Issued in NY

Practice address

1536 Crescent Rd
Clifton Park, NY 12065-7729

Phone

(518) 288-7054

NPI assigned

Jun 10, 2026

Last updated

Jun 10, 2026By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1781049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781049600000",
    "number": "1871427351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1536 CRESCENT RD",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120657729",
            "telephone_number": "518-288-7054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1536 CRESCENT RD",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120657729",
            "telephone_number": "518-288-7054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGONER",
        "first_name": "JESSICA",
        "middle_name": "SHIRLEY",
        "credential": "MS/OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-06-10",
        "last_updated": "2026-06-10",
        "certification_date": "2026-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "P142944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Clifton Park, NY
• Providers in Clifton Park, NY by specialty
• Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2026; 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.