Active NPI
Jennifer Wagner, CNM
- Advanced Practice Midwife
- Las Vegas, NV
National Provider Identifier
1962823252
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Advanced Practice Midwife
- License
- APRN001621
- Practice address
- 517 Rose St
Las Vegas, NV 89106-4020 - Phone
- (702) 438-4692
- Fax
- (702) 485-2372
- NPI assigned
- Jan 3, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | APRN001621 | NV | |
| Advanced Practice Midwife | 367A00000X | APRN001621 | NV | Primary |
Addresses
Primary practice location
517 Rose St
Las Vegas, NV 89106-4020
Mailing address
8906 Spanish Ridge Ave Ste 202
Las Vegas, NV 89148-1319
Phone (702) 330-3102
Other practice location 1
6250 N Durango Dr
Las Vegas, NV 89149-3916
Phone (702) 438-4692
Other practice location 2
3930 W Ann Rd
North Las Vegas, NV 89031-3841
Phone (702) 438-4692
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Midwife
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN001621 | NV | MD | Advanced Practice Midwife |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1388707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1608681600000",
"number": "1962823252",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8906 SPANISH RIDGE AVE STE 202",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891481319",
"telephone_number": "702-330-3102",
"fax_number": "702-912-4994"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "517 ROSE ST",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891064020",
"telephone_number": "702-438-4692",
"fax_number": "702-485-2372"
}
],
"practiceLocations": [
{
"address_1": "6250 N Durango Dr",
"address_purpose": "LOCATION",
"city": "Las Vegas",
"state": "NV",
"postal_code": "891493916",
"country_code": "US",
"telephone_number": "702-438-4692",
"fax_number": "702-485-2372",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3930 W Ann Rd",
"address_purpose": "LOCATION",
"city": "North Las Vegas",
"state": "NV",
"postal_code": "890313841",
"country_code": "US",
"telephone_number": "702-438-4692",
"fax_number": "702-485-2372",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WAGNER",
"first_name": "JENNIFER",
"credential": "CNM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-01-03",
"last_updated": "2020-12-23",
"certification_date": "2020-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NV",
"license": "APRN001621",
"primary": false
},
{
"code": "367A00000X",
"taxonomy_group": "",
"desc": "Advanced Practice Midwife",
"state": "NV",
"license": "APRN001621",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.