ASHLEY CHRISTINE WAGNER (NPI# 1104382936) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104382936 |
| Entity Type | Individual |
| Full Name | ASHLEY CHRISTINE WAGNER |
| Practice Address |
3724 Executive Center Dr Ste G10 Austin TX 78731-1665 |
| Mailing Address |
428 Lewisville Ln Leander TX 78641-4046 |
| Practice Telephone | 5123249720 |
| Mailing Telephone | 3615002803 |
| Enumeration Date | 2019-02-18 |
| Last Update Date | 2019-02-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2083S0010X |
Preventive Medicine Specialization: Sports Medicine |
AT5055 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | STATE OF TEXAS LICENSURE | AT5055 | 01 |
| BOARD OF CERTIFICATION | 2000007383 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093315897 | Ashley Wagner | Behavioral Analyst | 9905 Timberview Way, Louisville, KY 40223-3559 | 2020-10-29 |
| 1447879689 | Ashley Wagner | Licensed Vocational Nurse | 2726 3rd Ave, Groves, TX 77619-2614 | 2020-04-08 |
| 1952878803 | Ashley Ryan Wagner | Nurse Practitioner | 2560 Central Park Ave Ste 200, Flower Mound, TX 75028-1566 | 2018-10-30 |
| 1528547700 | Ashley Wagner | Specialist/Technologist | 1630 Market Place Dr, Maumee, OH 43537-3847 | 2018-08-09 |
| 1972946051 | Ashley Wagner | Social Worker | 3200 West Liberty, Ann Arbor, MI 48103 | 2013-04-09 |
| 1972129757 | Ashley Lynn Wagner | Nurse Practitioner | 2820 Mount Rushmore Rd, Rapid City, SD 57701-5474 | 2020-06-17 |
| 1508491044 | Ashley Wagner | Behavior Technician | 2785 Som Center Rd, Willoughby Hills, OH 44094-6501 | 2020-03-05 |
| 1174168819 | Ashley Wagner | Behavior Technician | 5530 Corbin Ave Ste 221, Tarzana, CA 91356-6095 | 2019-11-15 |
| 1407499551 | Ashley Bedelia Wagner | Dietitian, Registered | 2000 Olathe, Kansas City, KS 66160-7834 | 2019-10-22 |
| 1720597370 | Ashley Lynn Wagner | Physician Assistant | 1240 Huffman Mill Rd, Burlington, NC 27215 | 2017-09-27 |
| Street Address |
3724 EXECUTIVE CENTER DR STE G10 |
| City | AUSTIN |
| State | TX |
| Zip Code | 78731-1665 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023093861 | Lisa L Howard | Occupational Therapist | 3724 Executive Center Dr Ste G10, Austin, TX 78731-1665 | 2005-12-14 |
| 1588146781 | Lindsey Yee | Physical Therapist | 3724 Executive Center Dr Ste G10, Austin, TX 78731-1665 | 2018-09-04 |
| 1538281373 | Spine Clinic Ptpp Inc | Specialist | 3724 Executive Center Dr Ste G10, Austin, TX 78731-1665 | 2007-04-04 |
| 1831208081 | James Hansen | Neurological Surgery | 3724 Executive Center Dr Ste G10, Austin, TX 78731-1665 | 2006-08-30 |
| 1295848257 | Austin Neurosurgical and Spine Institute, Pa | Physician Assistant | 3724 Executive Center Dr Ste G10, Austin, TX 78731-1665 | 2006-08-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033710892 | Anew Era Tms & Psychiatry of Texas, Pa | Psychiatry & Neurology | 7514 N Mopac Expressway, Suite 100, Austin, TX 78731 | 2020-11-06 |
| 1962016519 | Jennie Rose Posey | Clinical Nurse Specialist | 6500 N. Mopac Expressway, Building 3, Suite 200, Austin, TX 78731 | 2020-09-01 |
| 1437772373 | Sharon Polackal | Student in an Organized Health Care Education/Training Program | Shoal Creek Hospital, 3501 Mills Avenue, 6th Floor, Austin, TX 78731 | 2020-05-27 |
| 1699309773 | Modern Vision Group, Pllc | Optometrist | 3908 Far W Blvd, Austin, TX 78731 | 2020-02-27 |
| 1235699562 | Catherine Kerrigan | Social Worker | 7514 N Mopac Expy, Suite 100, Austin, TX 78731 | 2019-03-22 |
| 1912474651 | Austin Dental Spa, Pllc | Dentist | 3305 Northland Ste 515, Austin, TX 78731 | 2018-10-31 |
| 1982110938 | Lindsey Sheppard | Dietitian, Registered | 7000 N Mopac Expy, Suite 200, Austin, TX 78731 | 2017-12-28 |
| 1144746066 | Sarah Cotton | Occupational Therapist | 3520 Executive Center Drive, Suite 128, Austin, TX 78731 | 2017-08-22 |
| 1699299792 | Avoia Mia Tapia | Physical Therapist | 3721 Executive Center Drive, Suite 201, Austin, TX 78731 | 2017-07-31 |
| 1265889745 | Home Focus Aba | Behavioral Analyst | 6804 Capital of Tx Hwy N 412, Austin, TX 78731 | 2016-05-16 |
| Find all providers in zip 78731 | ||||
| Taxonomy Code | 2083S0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Preventive Medicine |
| Specialization | Sports Medicine |
| A preventive medicine physician who specializes in the diagnosis and treatment of sports related conditions and injuries. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Preventive Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811506538 | Regenerate Atx Pllc | Preventive Medicine | 11610 Fm 2244 Rd Ste 230, Austin, TX 78738-5457 | 2020-07-28 |
| 1952378556 | David B. Tsai, M.d., P.a. | Preventive Medicine | 210 Barton Springs Rd, Suite 200, Austin, TX 78704-1254 | 2006-03-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063057602 | Heather Penka | Preventive Medicine | 820 Holiday Ln, North Richland Hills, TX 76180 | 2019-11-07 |
| 1588030241 | Texas A&m University | Preventive Medicine | 12 John David Crow Blvd, College Station, TX 77843 | 2015-08-18 |
| 1013526201 | Kimberly Moore | Preventive Medicine | 1333 W Washington St, Stephenville, TX 76401-4168 | 2020-07-24 |
| 1891269056 | Deidre Bibb | Preventive Medicine | 1814 Roseland Blvd Ste 100, Tyler, TX 75701-4262 | 2019-01-21 |
| 1891169686 | Tracy Coleman IIi | Preventive Medicine | 6000 Eldorado Pkwy, Apt# 222, Frisco, TX 75033-3573 | 2015-11-17 |
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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.