CAITLIN E WAGNER (NPI# 1265042014) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265042014 |
| Entity Type | Individual |
| Full Name | CAITLIN E WAGNER |
| Credential | AA |
| Practice Address |
10010 Kennerly Rd Saint Louis MO 63128-2106 |
| Mailing Address |
Po Box 22407 Saint Louis MO 63126-0407 |
| Practice Telephone | 6363867222 |
| Mailing Telephone | 6363867222 |
| Enumeration Date | 2020-08-06 |
| Last Update Date | 2020-09-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367H00000X | Anesthesiologist Assistant | 2020029245 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982975470 | Caitlin Ruth Wagner | Adult Companion | 501 Market St, Lewisburg, PA 17837-3002 | 2012-01-16 |
| 1841442365 | Caitlin Wagner | Counselor | 177 Pearl St, Burlington, VT 05401-3704 | 2008-10-15 |
| Street Address |
10010 KENNERLY RD |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63128-2106 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659374908 | Udayshanker Kasinadhuni | Anesthesiology | 10010 Kennerly Rd, Saint Louis, MO 63128-2106 | 2005-05-31 |
| 1598376287 | Laura Mayer | Dietitian, Registered | 10010 Kennerly Rd, Saint Louis, MO 63128-2106 | 2020-08-14 |
| 1881215424 | Samantha Broughton | Nurse Practitioner | 10010 Kennerly Rd, Saint Louis, MO 63128-2106 | 2020-05-06 |
| 1437779444 | Kathleen Stebe | Physical Therapist | 10010 Kennerly Rd, Saint Louis, MO 63128-2106 | 2020-04-20 |
| 1073148052 | Carly Pruemer | Nurse Anesthetist, Certified Registered | 10010 Kennerly Rd, Saint Louis, MO 63128-2106 | 2020-03-10 |
| 1568097541 | Altan Halici | Nurse Anesthetist, Certified Registered | 10010 Kennerly Rd, Saint Louis, MO 63128-2106 | 2020-03-10 |
| 1326673310 | Rhyz Wilson | Nurse Anesthetist, Certified Registered | 10010 Kennerly Rd, Saint Louis, MO 63128-2106 | 2020-03-10 |
| 1669007654 | Megan Hahn | Nurse Anesthetist, Certified Registered | 10010 Kennerly Rd, Saint Louis, MO 63128-2106 | 2020-03-10 |
| 1851925085 | Katie Walsh | Nurse Practitioner | 10010 Kennerly Rd, Saint Louis, MO 63128-2106 | 2020-02-26 |
| 1558912824 | Kristy Marie Dehne | Nurse Practitioner | 10010 Kennerly Rd, Saint Louis, MO 63128-2106 | 2019-09-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235771155 | James T Fetsch Dmd LLC | Dentist | 10004 Kennerly Rd Suite 240, Saint Louis, MO 63128 | 2019-10-11 |
| 1326504655 | Nikodem Dental Holdings | Dentist | 4337 Butler Hill Rd Suite G, St Louis Mo, MO 63128 | 2019-02-12 |
| 1932678505 | Michelle Anne Arvidson | Physical Therapy Assistant | Elite Physical Therapy, 12608 Lamplighter Square Shopping Center, St. Louis, MO 63128 | 2018-11-13 |
| 1245726710 | Kristen Rider | Nurse Practitioner | 9964 Kennerly Rd Ste D, Saint Louis, MO 63128 | 2018-07-07 |
| 1306217427 | Sophia Bednarski | Dentist | 12660 Lamplighter Square Shopping Center, St. Louis, MO 63128 | 2015-10-15 |
| 1427434224 | Darcie Burrus | Counselor | 12523 Old Tesson Rd G, St Louis, MO 63128 | 2015-08-04 |
| 1710368584 | Sara Hawatmeh | Internal Medicine | 12345 W Bend Dr Ste 304, Saint Louis, MO 63128 | 2015-06-17 |
| 1871989590 | Celia Grace Montes-kolence | Speech-Language Pathologist | 12335 W Bend Drive, Saint Louis, MO 63128 | 2015-04-09 |
| 1245629302 | Marius Antonio Evans | Dentist | 9911 Kennerly Rd., Suite G, St. Louis, MO 63128 | 2015-01-13 |
| 1801230313 | Sarah Elizabeth Walsh | Emergency Medicine | 10010 Kennerly Road, Emergency Department, St. Anthony's Medical Center, St. Louis, MO 63128 | 2013-04-26 |
| Find all providers in zip 63128 | ||||
| Taxonomy Code | 367H00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Anesthesiologist Assistant |
| An individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants are required to have a bachelor's degree with a premed curriculum prior to entering a two-year anesthesiology assistant program, which is focused upon the delivery and maintenance of anesthesia care as well as advanced patient monitoring techniques. An Anesthesiologist Assistant must work as a member of the anesthesia care team under the direction of a qualified Anesthesiologist. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174956163 | Sara Leitner | Anesthesiologist Assistant | 2420 Menard St, Saint Louis, MO 63104-4330 | 2013-08-14 |
| 1083231070 | Lauren Gonzalez | Anesthesiologist Assistant | 615 S New Ballas Rd, Saint Louis, MO 63141-8221 | 2020-06-25 |
| 1124643622 | Adam Z Zino | Anesthesiologist Assistant | 615 S New Ballas Rd, Saint Louis, MO 63141-8221 | 2020-06-10 |
| 1679196364 | Hannah Sneyd | Anesthesiologist Assistant | 615 S New Ballas Rd, Saint Louis, MO 63141-8221 | 2020-05-28 |
| 1922621812 | Daniel J Stelzer | Anesthesiologist Assistant | 615 S New Ballas Rd, Saint Louis, MO 63141-8221 | 2020-05-26 |
| 1104448059 | Nikolai Mckoy | Anesthesiologist Assistant | 615 S New Ballas Rd, Saint Louis, MO 63141-8221 | 2020-05-14 |
| 1164044921 | Nailah Newkirk | Anesthesiologist Assistant | 615 S New Ballas Rd, Saint Louis, MO 63141-8221 | 2020-05-14 |
| 1760004543 | Christian Gage Ortiz | Anesthesiologist Assistant | 615 S New Ballas Rd, Saint Louis, MO 63141-8221 | 2020-05-14 |
| 1467073981 | Eric N Enache | Anesthesiologist Assistant | 615 S New Ballas Rd, Saint Louis, MO 63141-8221 | 2020-05-06 |
| 1629602578 | Michael William Bean | Anesthesiologist Assistant | 615 S New Ballas Rd, Saint Louis, MO 63141-8221 | 2020-03-01 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63128 |
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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.