{"npi":"1699863894","type":"NPI-1","status":"active","name":{"display":"Mrs. Berneeta Wagoner Lisw","other":[],"first":"BERNEETA","last":"WAGONER","middle":"L","credential":"LISW"},"specialty":{"primary_taxonomy":"104100000X","primary_taxonomy_description":"Social Worker","slug":"social-worker","schema_org_specialty":null,"all":[{"code":"104100000X","description":"Social Worker","primary":true,"state":"IA","license":"00391"}]},"addresses":[{"purpose":"LOCATION","street_1":"215 E WASHINGTON ST","city":"CLARINDA","state":"IA","postal_code":"516321625","country_code":"US","phone":"7125423501","fax":"7125424725"},{"purpose":"MAILING","street_1":"215 E WASHINGTON ST","city":"CLARINDA","state":"IA","postal_code":"516321625","country_code":"US","phone":"7125423501","fax":"7125424725"}],"license":{"state":"IA","number":"00391"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"6571310","state":"SD","issuer":null},{"type_code":"01","label":"Other","value":"0427013","state":"IA","issuer":"IOWA MEDICAID ENTERPRISE"},{"type_code":"01","label":"Other","value":"7320","state":null,"issuer":"MIDLANDS CHOICE"},{"type_code":"01","label":"Other","value":"129079","state":null,"issuer":"VALUE OPTIONS"},{"type_code":"01","label":"Other","value":"58316","state":null,"issuer":"WELLMARK"}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20040127000435","type_code":"14-80","type_desc":"PRACTITIONER - CLINICAL SOCIAL WORKER","state":"IA","pac_id":"8820990096"}]},"enumeration_date":"2006-10-11","last_updated":"2007-12-18","_meta":{"source":"NPPES","snapshot_date":"2007-12-18","doc_url":"https://findmynpi.com/api"}}