Penina Wagshall

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

7894 Issued in CT

Practice address

129 Farmington Ave
Waterbury, CT 06710-1739

Phone

(347) 756-0707

NPI assigned

Dec 12, 2019

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Penina Martin Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Cheshire Fitness Zone, LLC

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  • NPI 1205961547

  Specialist

  NPD (past)

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

{
    "created_epoch": "1576108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736985600000",
    "number": "1962040766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 FARMINGTON AVE",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067101739",
            "telephone_number": "347-756-0707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 FARMINGTON AVE",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067101739",
            "telephone_number": "347-756-0707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGSHALL",
        "first_name": "PENINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-12",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CT",
            "license": "7894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PENINA",
            "last_name": "MARTIN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Janet L Vodra, MD
• David Vogel, M.D.
• Jennifer Volpe
• W.H. Pickett Drug Co
• Beverly Waczek
• Alan S. Waitze, M.D.
• Chana Wakszul, SLP
• Wal-Mart Stores East LP
• Wal-Mart Stores East, LP
• Melissa Walder

• Speech-Language Pathologist in Waterbury, CT
• Providers in Waterbury, CT by specialty
• Speech-Language Pathologist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2025; 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.