SAMANTHA ANN WAGNER (NPI# 1770943078) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770943078 |
| Entity Type | Individual |
| Full Name | SAMANTHA ANN WAGNER |
| Credential | ATC, LAT, CES |
| Practice Address |
170 Athletic Ctr Stillwater OK 74078-0001 |
| Mailing Address |
4599 N Washington St Apt 4f Stillwater OK 74075-1278 |
| Practice Telephone | 4057447823 |
| Mailing Telephone | 9373086354 |
| Enumeration Date | 2016-02-29 |
| Last Update Date | 2016-02-29 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
914 | OK | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | OKLAHOMA STATE BOARD OF MEDICAL LICENSURE AND SUPERVISION | 914 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083245781 | Samantha Nicole Wagner | Behavior Technician | 1563 Kingsley Ave Ste 103, Orange Park, FL 32073-4503 | 2020-01-31 |
| 1538631114 | Samantha Elizabeth Wagner | Nurse Practitioner | 209 9th St, Rockford, IL 61104-2235 | 2018-12-20 |
| 1689151391 | Samantha Wagner | Pharmacist | 410 W 10th Ave, 368 Doan Hall, Columbus, OH 43210 | 2018-07-25 |
| 1124524608 | Samantha Wagner | Social Worker | 8616 Northern Ave, Rockford, IL 61107-5309 | 2018-04-03 |
| 1013415199 | Samantha Brooke Wagner | Counselor | 3230 Waring Ct Ste A, Oceanside, CA 92056-4509 | 2018-01-24 |
| 1598272429 | Samantha Rose Wagner | Social Worker | 8261 Market St, Boardman, OH 44512-6254 | 2017-12-31 |
| 1528595394 | Samantha Louise Wagner | Student in an Organized Health Care Education/Training Program | 705 Riley Hospital Dr, Indianapolis, IN 46202-5109 | 2017-05-11 |
| 1508311622 | Samantha M Wagner | Registered Nurse | 191 N Main St, Wellsville, NY 14895-1150 | 2016-08-18 |
| 1134559966 | Samantha Wagner | Behavioral Analyst | 16782 Von Karman Ave Ste 11, Irvine, CA 92606 | 2013-11-14 |
| 1669801791 | Samantha Wagner | Social Worker | 30 Prospect Ave, Hackensack, NJ 07601-1914 | 2013-11-08 |
| Street Address |
170 ATHLETIC CTR |
| City | STILLWATER |
| State | OK |
| Zip Code | 74078-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477930428 | Claire Williams | Specialist/Technologist | 170f Athletics Center, Stillwater, OK 74078 | 2015-04-29 |
| 1114216959 | Kara Sue Niccum | Counselor | 320 Student Union, Stillwater, OK 74078 | 2011-04-01 |
| 1992028971 | Trevor Richardson | Psychologist | 316 Student Union, Stillwater, OK 74078 | 2010-03-05 |
| 1639391584 | Jason R Miller | Specialist/Technologist | Oklahoma State University, Athletics Center, Stillwater, OK 74078 | 2007-05-02 |
| 1396877957 | Thomas Jai Gross | Counselor | 434 Willard Hall, Oklahoma State University, Stillwater, OK 74078 | 2007-03-09 |
| 1043373533 | Val Gene Iven | Internal Medicine | 170 Athletics Center, Osu Sportsmedicine, Stillwater, OK 74078 | 2006-12-18 |
| 1851940365 | Sherri Norton | Speech-Language Pathologist | 042 Murray Hall, Stillwater, OK 74078 | 2019-09-06 |
| 1629224720 | Kristi Dee Carpenter | Speech-Language Pathologist | 042 Murray Hall, Stillwater, OK 74078 | 2008-08-08 |
| 1700994878 | Oklahoma State University | Audiologist | 042 Murray, Stillwater, OK 74078 | 2006-08-28 |
| 1922658301 | James Kenneth Jefferson | Specialist/Technologist | 200 Athletic Center Gallagher Iba Arena, Stillwater, OK 74078-0001 | 2019-09-17 |
| Find all providers in zip 74078 | ||||
| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
| Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922658301 | James Kenneth Jefferson | Specialist/Technologist | 200 Athletic Center Gallagher Iba Arena, Stillwater, OK 74078-0001 | 2019-09-17 |
| 1235603192 | Antonio La Don Davis | Specialist/Technologist | 820 1/2 S Knoblock St, Stillwater, OK 74074-4528 | 2019-01-14 |
| 1184107617 | Koki Ozawa | Specialist/Technologist | Oklahoma State University Athletics Center, Stillwater, OK 74078-0001 | 2018-09-11 |
| 1407349806 | Emma Kathryn Stratmoen | Specialist/Technologist | 1140 Creekside Cir, Stillwater, MN 55082-9651 | 2018-06-11 |
| 1598212201 | Alicea Emily Taylor-meza | Specialist/Technologist | 200 Athletic Center, Stillwater, OK 74078-4635 | 2016-09-10 |
| 1265888960 | Cady Coshow | Specialist/Technologist | 213 W Elm Ave, Apt 219, Stillwater, OK 74074-3300 | 2016-05-11 |
| 1659738136 | Courtney Anne Putnam | Specialist/Technologist | 2625 S Cambridge Dr, Stillwater, OK 74074-2246 | 2016-01-28 |
| 1184001919 | Grant Rohrig | Specialist/Technologist | 8727 Jeffrey Ave North, Stillwater, MN 55082 | 2015-04-30 |
| 1477930428 | Claire Williams | Specialist/Technologist | 170f Athletics Center, Stillwater, OK 74078 | 2015-04-29 |
| 1942576392 | Jessica Renee Cates | Specialist/Technologist | 170 Athletics Ctr, Gallagher Iba Arena, Stillwater, OK 74078-0001 | 2012-03-30 |
| Find all providers in STILLWATER | ||||
| City | STILLWATER |
| Zip Code | 74078 |
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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.