Erik W Wagner, F.N.P.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP4826 Issued in AZ

Practice address

4838 E. Baseline Rd.
BLDG 2, Suite 109
Mesa, AZ 85206-4677

Phone

(480) 969-4040

Fax

(480) 830-1042

NPI assigned

Aug 9, 2006

Last updated

Nov 21, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AZ

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

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mulberry Medical LLCGroup PAC ID 2365954450, 30 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14483/brand/1/csg/1/fhir/r4
• FHIR API: https://fhir4.healow.com/fhir/r4/AHHIDD

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

• Mulberry Medical LLC

  • Family Medicine Physician
  • Tempe, AZ
  • NPI 1831980986
  Medicare reassignment Care Compare group NPD
• George Wang,MD,LLC

  dba Neurology & Sleep Medicine Assoc

  • Neurology Physician
  • Mesa, AZ
  • NPI 1184679201
  Medicare reassignment NPD
• DCX2, P.C.

  dba Chaparral Chiropractic and Medical Clinic

  • Chiropractor
  • Scottsdale, AZ
  • NPI 1578936613
  NPD
• George Wang,MD,LLC

  dba AZ Pain Management and Neurology

  • Multi-Specialty Clinic/Center
  • Gilbert, AZ
  • NPI 1972077220
  NPD
• Phoenix Neurological Institute, Inc

  dba Phoenician Behavioral Health

  • Neurology Physician
  • Chandler, AZ
  • NPI 1336319086
  NPD (past)
• Plastic and Peripheral Nerve Surgery LLC

  • Plastic and Reconstructive Surgery Physician
  • Sun Lakes, AZ
  • NPI 1760044325
  NPD (past)
• Triad Chiropractic & Rehabilitation Clinics, LLC

  • Independent Medical Examiner Chiropractor
  • Tempe, AZ
  • NPI 1326362807
  NPD (past)

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574294400000",
    "number": "1033129150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4824 E BASELINE RD",
            "address_2": "SUITE 110",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064676",
            "telephone_number": "480-969-4040",
            "fax_number": "480-830-1042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4838 E. BASELINE RD.",
            "address_2": "BLDG 2, SUITE 109",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064677",
            "telephone_number": "480-969-4040",
            "fax_number": "480-830-1042"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4838 E. BASELINE RD.",
            "address_2": "BLDG 2, SUITE 109",
            "address_purpose": "LOCATION",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064677",
            "country_code": "US",
            "telephone_number": "480-626-2552",
            "fax_number": "480-626-2551",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "ERIK",
        "middle_name": "W",
        "credential": "F.N.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2019-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "TAP4826",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP4826",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "825839",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "Z233314",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rick C Wade, ATC
• Harpreet Singh Wadhwa, MD
• Scott S Wagers
• Aniruddha Wagh, DDS
• Amy Lynn Wagner, NMD
• Jennifer Wagner, LAMFT
• Joseph E. Wagner, M.D.
• Maralee A Wagner, NP-C
• Nicole Wagner
• Nina Marie Wagner

• Family Nurse Practitioner in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.