James Everett Wagner, BS, QMHA

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

1175 E Main St Ste 1C
Medford, OR 97504-7457

Phone

(541) 772-0127

NPI assigned

Mar 17, 2017

Last updated

Feb 26, 2018By the provider in NPPES

Sex

Male

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science

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

{
    "created_epoch": "1489708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519603200000",
    "number": "1952842346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 SW RAMSEY AVE",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975275500",
            "telephone_number": "541-474-5579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 E MAIN ST STE 1C",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047457",
            "telephone_number": "541-772-0127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "JAMES",
        "middle_name": "EVERETT",
        "credential": "BS, QMHA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-17",
        "last_updated": "2018-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1952842346",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kareem Wade
• Pushkar S Wadgaonkar, MD
• Martina Waggener
• April M Waggoner
• Christopher Wagner, RN
• Kell Wagner, NCC, LPC ASSOCIATE
• Caleb Mark Wagoner, FNP-C
• Lisa Wagoner, P.T.A.
• Zhawen Wahpepah, LPC
• Corie Waite, LMT

• Peer Specialist in Medford, OR
• Providers in Medford, OR by specialty
• Peer Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2018; 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.