JASON FREDRICK WAGNER (NPI# 1720536691) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720536691 |
| Entity Type | Individual |
| Full Name | JASON FREDRICK WAGNER |
| Credential | APRN, LMHC, MCAP |
| Practice Address |
6075 Bathey Ln Naples FL 34116-7536 |
| Mailing Address |
12521 Sw 11th Ct Davie FL 33325-5585 |
| Practice Telephone | 2394558500 |
| Mailing Telephone | 9544835455 |
| Enumeration Date | 2016-09-20 |
| Last Update Date | 2019-11-16 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
MH8961 | FL | Behavioral Health & Social Service Providers |
| N | 101YM0800X |
Counselor Specialization: Mental Health |
MH8961 | FL | Behavioral Health & Social Service Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
APRN11004343 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053700765 | Jason Robert Wagner | Counselor | 8728 S 120 E, Sandy, UT 84070-1526 | 2015-01-19 |
| 1821427287 | Jason Leigh Wagner | Counselor | 505 5th St., Suite 520, Sioux City, IA 51101 | 2013-11-06 |
| 1376003517 | Jason Wagner | Student in an Organized Health Care Education/Training Program | 6431 Fannin St # 1.150, Houston, TX 77030-1501 | 2019-03-22 |
| 1215329420 | Jason Wagner | Counselor | 2405 28th St, Anacortes, WA 98221-2484 | 2015-02-25 |
| 1457753519 | Jason Wagner | Physician Assistant | 2025 E Route 66, Glendora, CA 91740-4670 | 2014-09-19 |
| 1902168925 | Jason Kane Wagner | Surgery | 600 N Cattlemen Rd Ste 220, Sarasota, FL 34232-6422 | 2012-06-14 |
| 1093014334 | Jason Wagner | Counselor | 360 Whiskey Hill Rd, Watsonville, CA 95076-8521 | 2011-03-25 |
| 1588729768 | Jason E Wagner | Internal Medicine | 3400 Civic Center Blvd, West Pavilion 1st Fl, Philadelphia, PA 19104-5127 | 2006-12-27 |
| 1689641961 | Jason C Wagner | Emergency Medicine | 400 S Kingshighway Blvd, Saint Louis, MO 63110-1014 | 2006-03-05 |
| 1972594471 | Jason Michael Wagner | Radiology | 940 Ne 13th St, Suite 4g4250, Oklahoma City, OK 73104-5008 | 2005-11-03 |
| Street Address |
6075 BATHEY LN |
| City | NAPLES |
| State | FL |
| Zip Code | 34116-7536 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801891940 | David Lawrence Mental Health Center, Inc | Clinic/Center | 6075 Bathey Ln, Naples, FL 34116-7536 | 2005-06-16 |
| 1790383073 | Jada Stone Anastasia | Nurse Practitioner | 6075 Bathey Ln, Naples, FL 34116-7536 | 2020-10-09 |
| 1831711035 | Claire Nancie Lubin | Registered Nurse | 6075 Bathey Ln, Naples, FL 34116-7536 | 2020-05-11 |
| 1134762917 | Tania Guerrier Castor | Nurse Practitioner | 6075 Bathey Ln, Naples, FL 34116-7536 | 2019-10-23 |
| 1699335893 | Suzanne Hermann-barros | Counselor | 6075 Bathey Ln, Naples, FL 34116-7536 | 2019-06-19 |
| 1972160679 | Kathleen Nealon | Social Worker | 6075 Bathey Ln, Naples, FL 34116-7536 | 2019-05-29 |
| 1184289811 | Reid Kirchhoff | Counselor | 6075 Bathey Ln, Naples, FL 34116-7536 | 2019-05-08 |
| 1326602632 | Catrina Lowance | Social Worker | 6075 Bathey Ln, Naples, FL 34116-7536 | 2019-04-23 |
| 1720545361 | Dairy Alfonso | Counselor | 6075 Bathey Ln, Naples, FL 34116-7536 | 2019-03-01 |
| 1457824377 | Mary Rand | Counselor | 6075 Bathey Ln, Naples, FL 34116-7536 | 2019-01-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366058455 | Angela Maria Eastman | Pharmacist | 4849 Golden Gate Parkway, Naples, FL 34116 | 2020-09-23 |
| 1841828167 | Annie Sanabria | Specialist/Technologist | 2117 Sunshine Blvd Apt A, Naples, FL 34116 | 2020-03-31 |
| 1487142519 | Yandra Teresa Alvarez I | Nursing Care | 4696 Golden Gate Pkwy., Apt:a, Naples, FL 34116 | 2018-04-24 |
| 1861933251 | Vivian Reyes Carmenate | Behavior Technician | 4425 19th Pl Sw, Naples, FL 34116 | 2017-03-17 |
| 1992108419 | Nery Cardenas | Social Worker | 11725 Collier Blvd Suite A-2, Naples, FL 34116 | 2014-09-29 |
| 1437459559 | Gifford Chiropractic & Neurodiagnostic Center, Pa | Chiropractor | 4930 Golden Gate Pkwy., Naples, FL 34116 | 2010-10-22 |
| 1194047704 | Jose Francisco Baldoquin | Pharmacist | Kmart 4955 Golden Gate Parkway, Naples, FL 34116 | 2010-02-23 |
| 1851627798 | Victor Antonio Delgado | Massage Therapist | 5321 27th Ave Sw, Naples, FL 34116 | 2009-10-28 |
| 1225362692 | Santa Barbara Pain and Injury Rehab LLC | Chiropractor | 2006 Santa Babara Blvd, Naples, FL 34116 | 2009-10-01 |
| 1336397462 | Julio Cesar Dejardens | General Practice | 5580 19th Ct. Sw Unit 2, Naples, FL 34116 | 2008-09-03 |
| Find all providers in zip 34116 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689283384 | Miguel Angel Molina Reynoso | Nurse Practitioner | 7211 Vanderbilt Beach Rd Ste 12, Naples, FL 34119-1476 | 2020-07-28 |
| 1316242464 | Andrea Danette Greco | Nurse Practitioner | 4575 North Rd, Naples, FL 34104-4064 | 2011-01-21 |
| 1871627661 | Betty King | Nurse Practitioner | 851 5th Ave N, Ste 306, Naples, FL 34102-5582 | 2007-03-15 |
| 1346314424 | Niki Saltzer X | Nurse Practitioner | 178 Vintage Cir, Apt 101, Naples, FL 34119-4772 | 2006-11-20 |
| 1164514105 | Nancy H. Dwyer | Nurse Practitioner | 5150 Tamiami Trl N, Suite #201, Naples, FL 34103-2812 | 2006-09-28 |
| 1356338651 | Elaine Marie Nailler | Nurse Practitioner | 848 Anchor Rode Dr, Naples, FL 34103-2740 | 2005-10-02 |
| 1790383073 | Jada Stone Anastasia | Nurse Practitioner | 6075 Bathey Ln, Naples, FL 34116-7536 | 2020-10-09 |
| 1003422577 | Octavia Deuschle | Nurse Practitioner | 950 6th Ave N, Naples, FL 34102-5633 | 2020-09-21 |
| 1134762917 | Tania Guerrier Castor | Nurse Practitioner | 6075 Bathey Ln, Naples, FL 34116-7536 | 2019-10-23 |
| 1053877225 | Sara A Aschebrook | Nurse Practitioner | 350 7th St N, Naples, FL 34102-5754 | 2019-02-13 |
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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.