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MR. KEVIN DALE WAGNER MSW
NPI 1215139894
Social Worker - Clinical in Poplar Bluff, MO

Active since June 05, 2007PECOS Enrolled
1500 N WESTWOOD BLVD, POPLAR BLUFF, MO 63901(573) 778-4631 Get Directions Write a Review

NPPES record last updated: December 26, 2013. Verified against the NPPES registry weekly; last sync: September 06, 2026.

About Mr. Kevin Dale Wagner Msw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. KEVIN DALE WAGNER MSW (NPI 1215139894) is an individual clinical provider in Poplar Bluff, Missouri, licensed in Missouri (SW 04619) and active in the NPI registry since June 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1215139894
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameMR. KEVIN DALE WAGNERCredential: MSW
Location Address1500 N WESTWOOD BLVDPoplar Bluff, MO 63901-3318
Mailing Address1500 N Westwood BlvdPoplar Bluff, MO 63901-3318 · (573) 778-4631
Phone(573) 778-4631
Sole ProprietorNo
Enumeration DateJune 5, 2007
Last NPPES UpdateDecember 26, 2013
✔ NPI 1215139894 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in MO · SW 04619
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
1500 N WESTWOOD BLVD, Poplar Bluff, MO 63901
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Other Identifiers 1

Medicaid498307107MO

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Kevin Dale Wagner Msw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63901 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $52.28 – $161.24
Typical copayment $0.00 (range $13.07 – $40.31)
Most-billed visit code NA
Established Patient
$65.71 typical visit price
range $16.30 – $131.05
Typical copayment $16.42 (range $4.07 – $32.76)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. KAYLA S MELTON O.D.
Optometrist
1500 N WESTWOOD BLVD
POPLAR BLUFF, MO 63901
Butler County (573) 778-4303
DR. MERCY RATHINI SABAPATHYPILLAI M.D.
Psychiatry & Neurology (Psychiatry)
1500 N WESTWOOD BLVD
POPLAR BLUFF, MO 63901
Butler County (573) 472-2139
AMANDA RENAE FLORY D.O.
Psychiatry & Neurology (Psychiatry)
1500 N WESTWOOD BLVD
POPLAR BLUFF, MO 63901
Butler County (573) 686-4151
MAGEN BARNES
Registered Nurse
1500 N WESTWOOD BLVD
POPLAR BLUFF, MO 63901
Butler County (573) 686-4151
MS. JOLENE M WOLF FNP
Nurse Practitioner
1500 N WESTWOOD BLVD
POPLAR BLUFF, MO 63901
Butler County (573) 686-4151
MR. OSCAR BRIAN SMITH I RRT
Respiratory Therapist, Registered
1500 N WESTWOOD BLVD
POPLAR BLUFF, MO 63901
Butler County (573) 686-4151
ROCHELLE POYNOR RRT
Respiratory Therapist, Registered
1500 N WESTWOOD BLVD
POPLAR BLUFF, MO 63901
Butler County (573) 686-4151
PAMELA G HARNESS LCSW
Social Worker (Clinical)
1500 N WESTWOOD BLVD
POPLAR BLUFF, MO 63901
Butler County (573) 686-4151

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kevin Wagner's NPI number?

The NPI number for Kevin Wagner is 1215139894. It was assigned to this individual provider in the NPPES registry on June 5, 2007.

Where is Kevin Wagner located?

Kevin Wagner practices at 1500 N Westwood Blvd, Poplar Bluff, MO 63901. The listed phone number is (573) 778-4631.

What is Kevin Wagner's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Kevin Wagner enrolled in Medicare?

Yes. Kevin Wagner is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kevin Wagner was last updated on December 26, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.