JAMES EVERETT WAGNER (NPI# 1952842346) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952842346 |
| Entity Type | Individual |
| Full Name | JAMES EVERETT WAGNER |
| Credential | BS, QMHA |
| Practice Address |
1175 E Main St Ste 1c Medford OR 97504-7457 |
| Mailing Address |
715 Sw Ramsey Ave Grants Pass OR 97527-5500 |
| Practice Telephone | 5417720127 |
| Mailing Telephone | 5414745579 |
| Enumeration Date | 2017-03-17 |
| Last Update Date | 2018-02-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 1952842346 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568965234 | James Wagner | Physical Therapy Assistant | 316 Madison St, Niles, MI 49120-3128 | 2018-03-08 |
| 1245740687 | James Wagner | Marriage & Family Therapist | 2324 University Ave W Ste 100, Saint Paul, MN 55114-8759 | 2017-10-11 |
| 1558754168 | James Edwin Wagner | Licensed Practical Nurse | 377 Peyton Road S W, Atlanta, GA 30311 | 2015-03-07 |
| 1598969545 | James William Wagner | Chiropractor | 9574 Murray Dr, La Mesa, CA 91942 | 2007-06-13 |
| 1326188293 | James George Wagner | Obstetrics & Gynecology | 8000 Ave. J.t. Pinero, Plaza Cayey, Of. 204, Cayey, PR 00736 | 2007-02-08 |
| 1851469480 | James P Wagner | Family Medicine | 708 Viand Street, Point Pleasant, WV 25550 | 2006-12-01 |
| 1255412615 | James Allen Wagner | Rehabilitation Counselor | 11301 Wilshire Bl., Los Angeles, CA 90073 | 2006-10-18 |
| 1073536934 | James D Wagner | Internal Medicine | 890 Beaver Grade Rd Ste 3, Moon Township, PA 15108-2653 | 2006-07-25 |
| 1295783256 | James M Wagner | Dentist | 2620 Regatta Dr, 110, Las Vegas, NV 89128-6891 | 2006-05-04 |
| 1306804448 | James Blake Wagner | Physical Therapist | 1525 Country Club Rd, Sherwood, AR 72120-5076 | 2006-05-01 |
| Street Address |
1175 E MAIN ST STE 1C |
| City | MEDFORD |
| State | OR |
| Zip Code | 97504-7457 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902094949 | Travis C Toll | Counselor | 1175 E Main St Ste 1c, Medford, OR 97504-7457 | 2007-10-03 |
| 1407337264 | Marlon Campos | Counselor | 1175 E Main St Ste 1c, Medford, OR 97504-7457 | 2018-08-28 |
| 1881108926 | Heather Nichole Daw | Counselor | 1175 E Main St Ste 1c, Medford, OR 97504-7457 | 2017-11-28 |
| 1982118022 | Jeremy Jones | Counselor | 1175 E Main St Ste 1c, Medford, OR 97504-7457 | 2017-11-28 |
| 1811409667 | Casandra Lynn Anderrson | Counselor | 1175 E Main St Ste 1c, Medford, OR 97504-7457 | 2017-11-02 |
| 1821500125 | Sarah Hollingworth | Counselor | 1175 E Main St Ste 1c, Medford, OR 97504-7457 | 2017-10-26 |
| 1306358783 | Anne Lois Dupree | Peer Specialist | 1175 E Main St Ste 1c, Medford, OR 97504-7457 | 2017-10-25 |
| 1881104057 | Aubrey Shaw | Counselor | 1175 E Main St Ste 1c, Medford, OR 97504-7457 | 2017-10-02 |
| 1437673688 | Lauren Vail | Psychologist | 1175 E Main St Ste 1c, Medford, OR 97504-7457 | 2017-07-31 |
| 1730600867 | Wei Tseng | Peer Specialist | 1175 E Main St Ste 1c, Medford, OR 97504-7457 | 2017-06-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225673833 | Lydia D Sneed | Behavioral Analyst | 3707 Citation Way, Suite 102, Medford, OR 97504 | 2019-11-07 |
| 1114577368 | Heather Ashley Fronek | Nurse Practitioner | 2825 E. Barnett Rd., Medford, OR 97504 | 2019-09-18 |
| 1255809109 | Justin Blasdel | Technician, Health Information | 3250 Lone Pine Rd, Medford, OR 97504 | 2018-11-08 |
| 1396220133 | Aimee K Michel | Massage Therapist | 3550 National Dr., Medford, OR 97504 | 2018-09-27 |
| 1437646908 | Zola Dental Medford LLC | Dentist | 922 E Main, Medford, OR 97504 | 2018-04-19 |
| 1376068015 | Megan Leggett | Counselor | 777 Murphy Road, Medford, OR 97504 | 2017-08-03 |
| 1023547536 | Joshua Morgan Rice | Dentist | 1117 E Main St Ste 1, Medford, OR 97504 | 2017-06-08 |
| 1427580232 | Paul James Dean | Counselor | 1175 Main St Ste 1c, Medford, OR 97504 | 2017-03-30 |
| 1811443542 | Taya Adams | Doula | 1201 Progress Dr #90, Medford, OR 97504 | 2016-09-01 |
| 1174076228 | Avalon Health Care - Hearthstone, LLC | Skilled Nursing Facility | 2091 E. Barnett Road, Medford, OR 97504 | 2016-07-25 |
| Find all providers in zip 97504 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265073282 | Brandon Wade Orr | Peer Specialist | 611 W 11th St Apt 2, Medford, OR 97501-3572 | 2019-10-01 |
| 1558829358 | Robert Crawford | Peer Specialist | 221 W Main St # B13, Medford, OR 97501-2728 | 2019-03-11 |
| 1063977858 | Hayley Jo Burns | Peer Specialist | 1362 Garfield St, Medford, OR 97501-3979 | 2019-02-05 |
| 1972962355 | Robin Clevenger | Peer Specialist | 301 S Ivy St, Medford, OR 97501 | 2016-02-15 |
| 1902288871 | Kelly Burrows | Peer Specialist | 817 N Central Ave, Suite C, Medford, OR 97501-5840 | 2015-06-26 |
| 1396351730 | Dana Alexzandria Bogdanove | Peer Specialist | 140 S Holly St, Medford, OR 97501-3113 | 2020-09-21 |
| 1609493873 | Heather Marie Getz | Peer Specialist | 200 Beatty St, Medford, OR 97501-5811 | 2020-07-02 |
| 1508483405 | Justin Karl Sacco | Peer Specialist | 140 S Holly St, Medford, OR 97501-3113 | 2020-06-26 |
| 1275156564 | Mayela Villa | Peer Specialist | 140 S Holly St, Medford, OR 97501-3113 | 2020-05-21 |
| 1427686021 | Richard Joseph Mccleary | Peer Specialist | 200 Beatty St, Medford, OR 97501-5811 | 2020-03-30 |
| Find all providers in MEDFORD | ||||
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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.