SOPHIE R. WAGNER, NM SPEECH-LANGUAGE PATHOLOGIST, LLC (NPI# 1144640947) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144640947 |
| Entity Type | Organization |
| Organization Name | SOPHIE R. WAGNER, NM SPEECH-LANGUAGE PATHOLOGIST, LLC |
| Practice Address |
1503 Central Ave Nw Unit 202 Albuquerque NM 87104-1180 |
| Practice Telephone | 5054018204 |
| Practice Fax Number | 5052323588 |
| Mailing Telephone | 5054018204 |
| Mailing Fax Number | 5052323588 |
| Enumeration Date | 2014-04-18 |
| Last Update Date | 2014-09-04 |
| Authorized Official Name | MS. CARYN WAGNER (OFFICE MANAGER) |
| Authorized Official Telephone | 5059805334 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QH0700X |
Clinic/Center Specialization: Hearing and Speech |
5431 | NM | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | MEDICAID, INDIVIDUAL PROVIDER ID, NOT BILLING PROVIDER ID | 81888228 | 01 |
| NM | CRS | 03272176005 | 01 |
| NM | 47631597 | 05 |
| Street Address |
1503 CENTRAL AVE NW UNIT 202 |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87104-1180 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467703694 | Sophie Ruth Wagner | Speech-Language Pathologist | 1503 Central Ave Nw, Unit 202, Albuquerque, NM 87104-1180 | 2012-09-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053839639 | Alicia Lovato | Pharmacist | 1731 Towner Ave Nw, Albuquerque, NM 87104 | 2017-09-05 |
| 1649650797 | Anna Marie L Dinallo | Counselor | 1602 Escalante Ave, Albuquerque L, NM 87104 | 2015-06-04 |
| 1487057246 | Larry Steve Archuleta Sr. Sr. | Counselor | 1611 Central Nw, Alb., NM 87104 | 2014-10-07 |
| 1386072866 | Bridges | Day Training, Developmentally Disabled Services | 1509 Los Jardines Place, Albuquerque, NM 87104 | 2013-10-22 |
| 1275974792 | Mary R. Gomez | Counselor | 1611 Central Ave. Nw, Albuq, NM 87104 | 2013-07-12 |
| 1861727992 | Corrianne H Broner | Counselor | 1208 Claire Court Nw, Albuquerque, NM 87104 | 2009-10-07 |
| 1578711545 | Raymond Louis Zoumar | Anesthesiology | 2312 Campbell Rd Nw, Albuquerque, NM 87104 | 2008-09-03 |
| 1972785756 | Rochelle Young | Counselor | 1316- A Granite Ave. Nw, Albuquerque, NM 87104 | 2007-12-03 |
| 1023134699 | Elizabeth Anne Ferrell | Dental Hygienist | 400 San Felipe Nw, Suite F, Albuquerque, NM 87104 | 2007-03-22 |
| 1366566705 | Abq Home Health Care Inc. | Home Health | 1600 Lomas Blvd Nw, Suite B, Albuquerque, NM 87104 | 2007-03-19 |
| Find all providers in zip 87104 | ||||
| Taxonomy Code | 261QH0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Hearing and Speech |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, prescriptive, and therapy services related to congenital and acquired conditions and diseases that affect hearing capacity and speech ability. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811233588 | Bilingual Interventions, LLC | Clinic/Center | 3805 Atrisco Dr Nw, Suite B, Albuquerque, NM 87120-4980 | 2012-12-27 |
| 1780043083 | Speech & Language A To Z, LLC | Clinic/Center | 6501 Wyoming Blvd Ne, Building C, Suite 115, Albuquerque, NM 87109-3932 | 2016-02-15 |
| 1720425523 | Hearing Aid Store, Inc | Clinic/Center | 8400 Menaul Blvd Ne, Suite F, Albuquerque, NM 87112-2260 | 2013-06-03 |
| 1215265491 | Rose Montgomery, M.s., Ccc, P.C. | Clinic/Center | 1420 Carlisle Blvd Ne, St. 201-e, Albuquerque, NM 87110-5660 | 2009-11-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528682945 | New Mexico Hearing Aid & Tinnitus Center LLC | Clinic/Center | 5553 Lilac Pl Ne, Rio Rancho, NM 87144-5804 | 2020-06-01 |
| 1790333532 | Exclusive Hearing Center LLC | Clinic/Center | 1161 Mall Dr Ste D, Las Cruces, NM 88011-8193 | 2019-08-26 |
| 1609345545 | Northland Hearing Center, Inc. | Clinic/Center | 107 S Second St, Gallup, NM 87301-6219 | 2018-11-21 |
| 1417430406 | Lazy River Therapy Services, LLC | Clinic/Center | 3 Road 3660, Aztec, NM 87410-9020 | 2018-09-14 |
| 1003338732 | Silver Tongue Speech & Voice, LLC | Clinic/Center | 3001 Northridge Dr Ste C, Farmington, NM 87401 | 2017-07-14 |
| 1831588052 | Land of Enchantment Audiology LLC | Clinic/Center | 264 S Camino Del Pueblo, Building B, Bernalillo, NM 87004-6070 | 2015-01-12 |
| 1629533641 | Zia Hearing Center, LLC | Clinic/Center | 4001 N Butler Ave Ste 5101, Farmington, NM 87401-2392 | 2019-02-04 |
| 1619482064 | Sunshine Kids Therapy, LLC | Clinic/Center | 325 S Main St Ste A, Belen, NM 87002-3503 | 2017-12-07 |
| 1902183155 | Kewa Pueblo Health Corporation | Clinic/Center | 85 W Highway 22, Santo Domingo, NM 87052-0340 | 2011-11-15 |
| City | ALBUQUERQUE |
| Zip Code | 87104 |
Please comment or provide details below to improve the information on SOPHIE R. WAGNER, NM SPEECH-LANGUAGE PATHOLOGIST, LLC.
| 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.