Bonnie K Wagner, M.S. / CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

3246 Issued in TN

Practice address

1501 12TH Ave S
Nashville, TN 37203-4909

Phone

(615) 933-0070

Fax

(615) 383-9489

NPI assigned

Jan 15, 2020

Last updated

Jan 15, 2020By 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

Enrolled in TN

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

University of Louisville School of Medicine, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Select Physical Therapy Holdings IncGroup PAC ID 9537076401, 1,992 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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

• Select Physical Therapy Holdings Inc

  dba Select Physical Therapy

  • Rehabilitation Clinic/Center
  • Smyrna, TN
  • NPI 1619939766
  Medicare reassignment Care Compare group NPD
• Healthpro Heritage Rehab & Fitness, LLC

  • Physical Therapist
  • Clinton, TN
  • NPI 1376073262

  Speech-Language Pathologist

  Medicare reassignment NPD
• Select Physical Therapy Holdings, Inc.

  dba Select Physical Therapy

  • Rehabilitation Clinic/Center
  • Murfreesboro, TN
  • NPI 1427011915
  NPD
• Healthpro Heritage Rehab & Fitness, LLC

  • Physical Therapist
  • Independence, MO
  • NPI 1871072462

  Speech-Language Pathologist

  NPD
• Select Physical Therapy Holdings Inc

  dba Select Physical Therapy

  • Physical Therapy Clinic/Center
  • Ashland, VA
  • NPI 1174591218
  NPD

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

{
    "created_epoch": "1579046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579046400000",
    "number": "1942840277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 12TH AVE S",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372034909",
            "telephone_number": "615-933-0070",
            "fax_number": "615-383-9489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 12TH AVE S",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372034909",
            "telephone_number": "615-933-0070",
            "fax_number": "615-383-9489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "BONNIE",
        "middle_name": "K",
        "credential": "M.S. / CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-15",
        "last_updated": "2020-01-15",
        "certification_date": "2020-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TN",
            "license": "3246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Marie Wagaman, PA-C
• Mezemir Fikremariam Wagaw
• Deborah Wage, CNM
• Anne Louise Lambert Wagner, MD, FACS
• Bethany Wagner, FNP
• Cynthia Carter Wagner, LMSW
• Derek Lamont Wagner, MD
• Franz Wagner, LPN
• Heather Jean Marie Wagner, B.S.
• Krystn Rae Wagner, MD

• Speech-Language Pathologist in Nashville, TN
• Providers in Nashville, TN by specialty
• Speech-Language Pathologist in Tennessee

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