MS. RACHELLE WAGNER (NPI# 1841364999) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841364999 |
| Entity Type | Individual |
| Full Name | MS. RACHELLE WAGNER |
| Credential | OTRL |
| Practice Address |
304 E 6th Ave Rome GA 30161-6000 |
| Mailing Address |
20 Greatwood Dr White GA 30184-2893 |
| Practice Telephone | 7063789044 |
| Practice Fax Number | 7063789046 |
| Mailing Telephone | 7063789044 |
| Mailing Fax Number | 7063789046 |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2007-07-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 171W00000X | Contractor | OT003702 | GA | Other Service Providers |
| X | 225X00000X | Occupational Therapist | OT003702 | GA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 10047143 | 05 | |
| GA | BLUE CROSS BLUE SHIELD | 52038467 | 01 |
| GA | 342685 | 05 |
| Street Address |
304 E 6TH AVE |
| City | ROME |
| State | GA |
| Zip Code | 30161-6000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790786275 | Beatrice Jarvis | Occupational Therapist | 304 E 6th Ave, Rome, GA 30161-6000 | 2005-08-09 |
| 1265050215 | Heather Rae Ribeiro | Physical Therapist | 304 E 6th Ave, Rome, GA 30161-6000 | 2020-07-07 |
| 1285275297 | Molly Mckenzie | Occupational Therapist | 304 E 6th Ave, Rome, GA 30161-6000 | 2019-10-01 |
| 1205481553 | Kara Katelyn Campos | Physical Therapist | 304 E 6th Ave, Rome, GA 30161-6000 | 2019-08-05 |
| 1558916809 | Christopher Michael Campos | Physical Therapist | 304 E 6th Ave, Rome, GA 30161-6000 | 2019-08-05 |
| 1073179180 | Hayden Ellis | Occupational Therapist | 304 E 6th Ave, Rome, GA 30161-6000 | 2019-05-14 |
| 1851815815 | Sarah Taylor Morrison | Physical Therapist | 304 E 6th Ave, Rome, GA 30161-6000 | 2017-08-01 |
| 1134650195 | Jegnasha Patel | Occupational Therapist | 304 E 6th Ave, Rome, GA 30161-6000 | 2017-03-22 |
| 1013390913 | Elvira Aguilar | Occupational Therapist | 304 E 6th Ave, Rome, GA 30161-6000 | 2015-07-09 |
| 1366839920 | Erin Hallum | Speech-Language Pathologist | 304 E 6th Ave, Rome, GA 30161-6000 | 2015-04-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265069256 | Three Rivers Housing and Development Corporation | Chore Provider | 326 W. 9th St, Rome, GA 30161 | 2020-03-27 |
| 1144865957 | Eric Alan Fuller | Audiologist-Hearing Aid Fitter | 700 East 2nd Street, Suite C, Rome, GA 30161 | 2019-11-15 |
| 1003394883 | Cindy V Shelton | Health Educator | 204 E 1st Ave, Rome, GA 30161 | 2018-08-02 |
| 1083153597 | Julie Oglesby Allen | Counselor | 1 S Broad St Sw Ste 5, Rome, GA 30161 | 2017-02-16 |
| 1902299530 | Michael Thomas Phillips | Pharmacist | 2005 Maple Street, Rome, GA 30161 | 2015-03-06 |
| 1407259112 | Angela Smith | Community/Behavioral Health | 109 John Maddox Suite 200, Rome, GA 30161 | 2014-10-08 |
| 1215344379 | Nancy Patel | Pharmacist | 1421 North Broad St, Rome, GA 30161 | 2014-07-21 |
| 1821336629 | Wendy Pence | Nurse Practitioner | 3001 Turner Mccall Blvd, Rome, GA 30161 | 2013-01-29 |
| 1558526202 | Marilyn Teresa Ringstaff | Registered Nurse | 1513 Dean St., Rome, GA 30161 | 2008-07-22 |
| 1134310147 | Reneka L Dobbs-jackson | Family Medicine | 420 E 2nd Ave Ste 103, Rome, GA 30161 | 2007-08-05 |
| Find all providers in zip 30161 | ||||
| Taxonomy Code | 171W00000X |
| Grouping | Other Service Providers |
| Classification | Contractor |
| A person who contracts to supply certain materials or do certain work for a stipulated sum; esp., one whose business is contracting work in any of the building trades. For purposes of the taxonomy, a person who contracts to complete home repairs or modifications to accommodate a health condition (e.g. wheelchair ramp, kitchen counter lowering). |
| Notes: Source: Websters New World Dictionary of the American Language, Second College Edition, William Collins + World Publishing Co., Inc., New York: 1974, p. 308 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053933234 | Richard Clay | Contractor | 111 E 14th St Sw, Rome, GA 30161-6388 | 2020-05-11 |
| 1992031058 | John Wayne Donaldson | Contractor | 1701 N Broad St Ne, Rome, GA 30161-5343 | 2009-10-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952900011 | Tamekia Richardson | Contractor | 861 Frank Rd, Fitzgerald, GA 31750-9049 | 2020-10-20 |
| 1285232777 | Khrystal Wright | Contractor | 4016 Foxborough Blvd, Valdosta, GA 31602-6726 | 2020-10-15 |
| 1922605690 | Mary Sonya Jackson | Contractor | 5480 Hedge Brooke Pointe Nw, Acworth, GA 30101-7142 | 2020-10-06 |
| 1790392652 | Najee Shafi | Contractor | 100 Archstone Sq, Mcdonough, GA 30253-5820 | 2020-09-24 |
| 1144837071 | Angela M Bodie | Contractor | 406 Carrington Green Pkwy, Mcdonough, GA 30252-7693 | 2020-09-24 |
| 1841806841 | Ashley De Plato | Contractor | 3813 Robin Ln, Valdosta, GA 31605-5124 | 2020-09-16 |
| 1407462401 | Pamela Woodard | Contractor | 868 Cochise Trl Se, Conyers, GA 30094-4538 | 2020-09-16 |
| 1821603606 | Sherenda Lashawn Ellis | Contractor | 1859 Petite Lane, Lithonia, GA 30058 | 2020-09-09 |
| 1316551377 | Holland Consulting Practice LLC | Contractor | 6307 Towne Lake Hts, Woodstock, GA 30189-4245 | 2020-09-07 |
| 1003420571 | Antonio Jones | Contractor | 700 Martin Luther King Jr Dr Sw Apt 206, Atlanta, GA 30314-4143 | 2020-09-02 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on MS. RACHELLE WAGNER.
| 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.