MRS. KELLY ANNE WAGNER (NPI# 1235562307) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235562307 |
| Entity Type | Individual |
| Full Name | MRS. KELLY ANNE WAGNER |
| Credential | SLP |
| Practice Address |
331 E Park St Weiser ID 83672-2053 |
| Practice Telephone | 2085490206 |
| Practice Fax Number | 2085490536 |
| Mailing Telephone | 2088902995 |
| Enumeration Date | 2013-08-13 |
| Last Update Date | 2013-08-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 235Z00000X | Speech-Language Pathologist | TSLP-2301 | ID | Speech, Language and Hearing Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013570746 | Kelly Susan Wagner | Speech-Language Pathologist | 8902 Old Harford Rd, Baltimore, MD 21234-2646 | 2019-04-18 |
| 1356808455 | Kelly Mcmahon Wagner | Social Worker | 4701 Greenspring Ave, Baltimore, MD 21209-4704 | 2019-02-25 |
| 1659744316 | Kelly Ann Wagner | Nurse Practitioner | 10410 Abercorn Expressway, Savannah, GA 31419 | 2015-11-03 |
| 1659612745 | Kelly Ann Wagner | Specialist | 727 Carmen Dr, Norristown, PA 19401-3545 | 2013-03-14 |
| 1881925592 | Kelly Danielle Wagner | Physical Therapy Assistant | 226 Fish Hall Rd, Brunswick, GA 31523-7405 | 2010-01-20 |
| 1407180268 | Kelly Ann Wagner | Licensed Practical Nurse | 1143 Vogt Dr Apt 14, West Bend, WI 53095-5505 | 2009-09-28 |
| 1295288629 | Kelly Wagner | Dietitian, Registered | 200 Hawkins Dr, Food and Nutrition Services, W146 Gh, Iowa City, IA 52242-1009 | 2016-08-02 |
| 1154776334 | Kelly Wagner | Student in an Organized Health Care Education/Training Program | 100 High St, C 378, Buffalo, NY 14203-1126 | 2016-04-26 |
| 1346613205 | Kelly Wagner | Naturopath | 185 Tilley Dr, Suite #51, South Burlington, VT 05403-4484 | 2015-11-01 |
| 1932510831 | Kelly Wagner | Pharmacist | 3360 Tittabawassee Rd, Saginaw, MI 48604-9453 | 2014-05-13 |
| Street Address |
331 E PARK ST |
| City | WEISER |
| State | ID |
| Zip Code | 83672-2053 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558384420 | Kindred Nursing Centers West, LLC | Skilled Nursing Facility | 331 E Park St, Weiser, ID 83672-2053 | 2006-07-25 |
| 1699255133 | Caren Shinayo Imada | Occupational Therapist | 331 E Park St, Weiser, ID 83672-2053 | 2018-08-15 |
| 1770062499 | Angela M Asp | Speech-Language Pathologist | 331 E Park St, Weiser, ID 83672-2053 | 2018-08-13 |
| 1821509134 | Weiser of Cascadia, LLC | Skilled Nursing Facility | 331 E Park St, Weiser, ID 83672-2053 | 2017-10-13 |
| 1134522543 | Judy Ann Carroll | Speech-Language Pathologist | 331 E Park St, Weiser, ID 83672-2053 | 2014-09-30 |
| 1033542196 | William David Pentecost | Occupational Therapy Assistant | 331 E Park St, Weiser, ID 83672-2053 | 2013-08-13 |
| 1609209782 | Nerissa Marie Scott | Physical Therapy Assistant | 331 E Park St, Weiser, ID 83672-2053 | 2013-08-13 |
| 1093147308 | Michael Lafferty | Physical Therapy Assistant | 331 E Park St, Weiser, ID 83672-2053 | 2013-08-08 |
| 1922260850 | Carmal Suzanne Chrisman | Occupational Therapist | 331 E Park St, Weiser, ID 83672-2053 | 2008-07-01 |
| 1407018518 | Karen Rene Lockwood | Occupational Therapy Assistant | 331 E Park St, Weiser, ID 83672-2053 | 2008-06-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891176798 | Christine Cooper | Nurse Practitioner | 35 W Idaho St, Weiser, ID 83672 | 2015-06-16 |
| 1356630941 | Jordan V Blanchard | Family Medicine | 360 E. Liberty, Weiser, ID 83672 | 2011-04-04 |
| 1427038231 | Christopher Earl Malloy | Dentist | 1067 Hwy 95, Weiser, ID 83672 | 2006-01-18 |
| 1457508418 | Christy Earlean Marvin | Home Health Aide | 1111 E Main St, Weiser, ID 83672 | 2008-08-21 |
| 1255364030 | Weiser Valley Hospital District | Orthopaedic Surgery | 645 E. 5th St., Weiser, ID 83672 | 2006-07-07 |
| 1568685543 | Weiser School District #431 | Specialist | 925 Pioneer Rd, Weiser, ID 83672-1146 | 2007-04-10 |
| 1275147712 | Madison Caldwell | Counselor | 925 Pioneer Rd, Weiser, ID 83672-1146 | 2020-09-02 |
| 1588108872 | Laura Haun | Specialist/Technologist | 275 Mcginnis Dr, Weiser, ID 83672-1262 | 2016-12-06 |
| 1073537486 | Bi-mart Corporation | Durable Medical Equipment & Medical Supplies | 1545 E 6th St, Weiser, ID 83672-1495 | 2006-07-27 |
| 1164047635 | Bridget Moore | Pharmacy Technician | 1545 E 6th St, Weiser, ID 83672-1495 | 2020-06-10 |
| Find all providers in zip 83672 | ||||
| Taxonomy Code | 235Z00000X |
| Grouping | Speech, Language and Hearing Service Providers |
| Classification | Speech-Language Pathologist |
| The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing. |
| Notes: "Scope of Practice in Speech-Language Pathology", American Speech-Language-Hearing Association, 2013. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770062499 | Angela M Asp | Speech-Language Pathologist | 331 E Park St, Weiser, ID 83672-2053 | 2018-08-13 |
| 1134522543 | Judy Ann Carroll | Speech-Language Pathologist | 331 E Park St, Weiser, ID 83672-2053 | 2014-09-30 |
| 1326475617 | Janice Elaine Grimaldo | Speech-Language Pathologist | 645 E 5th St, Weiser, ID 83672-2202 | 2013-10-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417573809 | Jaclyn Christine Harmon | Speech-Language Pathologist | 8620 W Emerald St Ste 100, Boise, ID 83704-4838 | 2020-06-22 |
| 1760008262 | Northwest Pediatric Speech Therapy, LLC | Speech-Language Pathologist | 1130 W Hayden Ave Ste 103, Hayden, ID 83835-8720 | 2020-06-19 |
| 1659908481 | Communication Steps, LLC | Speech-Language Pathologist | 8875 Butte Rd, Sweet, ID 83670-5005 | 2020-03-23 |
| 1275170383 | Angela M Abbott | Speech-Language Pathologist | 79 N Plummer Rd, Star, ID 83669-5561 | 2019-12-09 |
| 1669016689 | Amy Ochs | Speech-Language Pathologist | 239 N Storybook Way, Eagle, ID 83616-4891 | 2019-11-01 |
| 1679114060 | Amy L Doughty | Speech-Language Pathologist | 25844 Old Spiral Hwy, Lewiston, ID 83501-5893 | 2019-10-07 |
| 1669020988 | Sierra Kamplain | Speech-Language Pathologist | 700 Riverfront Dr Rm 4, Salmon, ID 83467-5190 | 2019-08-29 |
| 1346896149 | Susan Kathryn Rauma | Speech-Language Pathologist | 3378 N 3300 E, Kimberly, ID 83341-5266 | 2019-08-16 |
| 1740834134 | Katelyn Smith | Speech-Language Pathologist | 829 S Washington Ave Ste C, Emmett, ID 83617-3528 | 2019-07-24 |
| 1740833466 | Lindsay Winger | Speech-Language Pathologist | 152 E Maint St., #110, Rigby, ID 83442 | 2019-07-22 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.