JASON FREDRICK WAGNER APRN LMHC MCAP NPI 1720536691

NPI Information

  • NPI: 1720536691
  • Provider Name: JASON FREDRICK WAGNER, APRN, LMHC, MCAP
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 111 W CORAL WAY
    HOLLYWOOD, FL
    ZIP 33021
  • Phone: (954) 964-6338

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NPI Details

Jason Fredrick Wagner, APRN, LMHC, MCAP is a psychiatric/mental health nurse practitioner in Hollywood, FL with 6 years of experience. Jason Fredrick Wagner, APRN, LMHC, MCAP NPI is 1720536691. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

111 W CORAL WAY
HOLLYWOOD, FL
ZIP 33021-860
Phone: (954) 964-6338
Fax: (954) 965-1327

The NPI 1720536691 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • Follow-up hospital inpatient care per day, typically 35 minutes (HCPCS:99233)

The enumeration date for this NPI number is 9/20/2016 and was last updated on 5/1/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YA0400XCounselorAddiction (Substance Use Disorder)MH8961FLORIDANo
2101YM0800XCounselorMental HealthMH8961FLORIDANo
3363LP0808XNurse PractitionerPsychiatric/Mental HealthAPRN11004343FLORIDAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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