Samantha Wagner, RDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

86289910 Issued in CO

Practice address

2960 N Circle Dr Ste 200
Colorado Springs, CO 80909-1163

Phone

(719) 634-8891

NPI assigned

Dec 20, 2022

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

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

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.

• Weigh to Wellness Denver

  • Family Medicine Physician
  • Denver, CO
  • NPI 1568762698
  NPD

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

{
    "created_epoch": "1671494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671494400000",
    "number": "1942912019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2960 N CIRCLE DR STE 200",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809091163",
            "telephone_number": "719-634-8891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2960 N CIRCLE DR STE 200",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809091163",
            "telephone_number": "719-634-8891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "SAMANTHA",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-20",
        "last_updated": "2022-12-20",
        "certification_date": "2022-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CO",
            "license": "86289910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelsey Gabrielle Wagner
• Kimberly Lue Wagner, MD
• Matthew D Wagner
• Nora Wagner, PHARMD
• Rebecca Wagner, PH.D.
• Stephanie Wagner
• Taylor Wagner
• Robert Charles Wagstaff, LCSW
• Jace Michael Waguspack, PHD
• Amanda Wahl

• Registered Dietitian in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Registered Dietitian in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.