Individual provider Active NPI

Laura L Wagner, APRN, FNP

  • Family Nurse Practitioner
  • Texarkana, TX
National Provider Identifier
1013443589
Registry record updated May 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP134028 Issued in TX
Practice address
2717 Summerhill Rd
Texarkana, TX 75503-3957
Phone
(903) 792-1404
Fax
(903) 792-2681
NPI assigned
May 3, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP134028 TX Primary

Addresses

Primary practice location

2717 Summerhill Rd
Texarkana, TX 75503-3957

Mailing address

5002 Cowhorn Creek Rd
Texarkana, TX 75503-9766
Phone (903) 614-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170623000169 TX Practitioner - Nurse Practitioner 1456629039 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Unified Womens Healthcare of Texas PLLCGroup PAC ID 4385944230, 180 clinicians

Practice addresses (Care Compare)

2717 Summerhill Rd
Texarkana, TX 75503-3957
Phone (903) 792-1404

Hospital & facility affiliations

  • St Anthony Hospital Hospital, Pendleton, OR, CCN 381319

Merit-based Incentive Payment System (MIPS)

Final score
52.36 of 100Reported as group
Quality
24.02
Promoting interoperability
91
Improvement activities
0
Cost
74.69

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP134028TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Commonspirit Oregon Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: laura.jackson.p1@direct.collom-carney.nextgenshare.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1493769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779062400000",
    "number": "1013443589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5002 COWHORN CREEK RD",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755039766",
            "telephone_number": "903-614-3000",
            "fax_number": "903-614-3525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2717 SUMMERHILL RD",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755033957",
            "telephone_number": "903-792-1404",
            "fax_number": "903-792-2681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "LAURA",
        "middle_name": "L",
        "credential": "APRN, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-03",
        "last_updated": "2026-05-18",
        "certification_date": "2026-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP134028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Texarkana, TX

Sources for this page

Verify at the official NPI Registry.