Dara Marie Wagner, APN-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209020976 Issued in IL

Practice address

180 S Main St
Canton, IL 61520-2608

Phone

(309) 647-0201

NPI assigned

Feb 25, 2020

Last updated

Oct 20, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

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, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Graham Hospital AssociationGroup PAC ID 2769375021, 124 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Graham Hospital Association Hospital, Canton, IL, CCN 140001
• Graham Hospital Association Hospital, Canton, IL, CCN 141356

Merit-based Incentive Payment System (MIPS)

Final score

83.26 of 100Reported as group

Quality

62.57

Promoting interoperability

100

Improvement activities

40

Cost

77.37

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: records@awhc.directbygreenway.com
• Direct secure messaging: dara.wagner@gmgil.eclinicaldirectplus.com
• FHIR API: https://fhir4.healow.com/fhir/r4/IDGEAA/Endpoint/IDGEAA

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.

• Graham Hospital Association

  • Critical Access Hospital
  • Canton, IL
  • NPI 1780692087
  Medicare reassignment Care Compare group NPD
• Graham Hospital Association

  dba Knox & Fulton County Wound and Hyperbaric Medicine

  • Internal Medicine Physician
  • Galesburg, IL
  • NPI 1710845854
  NPD
• Graham Hospital Association

  dba Graham Medical Group Lewistown

  • Rural Health Clinic/Center
  • Lewistown, IL
  • NPI 1750527172
  NPD

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

• Graham Hospital Association

  • Critical Access Hospital
  • Canton, IL
  • NPI 1154117521
  Care Compare affiliation

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

{
    "created_epoch": "1582588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634688000000",
    "number": "1063046464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 S MAIN ST",
            "city": "CANTON",
            "state": "IL",
            "postal_code": "615202608",
            "telephone_number": "309-647-0201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 S MAIN ST",
            "city": "CANTON",
            "state": "IL",
            "postal_code": "615202608",
            "telephone_number": "309-647-0201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "DARA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "APN-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-25",
        "last_updated": "2021-10-20",
        "certification_date": "2021-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209020976",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209020976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dara.wagner@gmgil.eclinicaldirectplus.com",
            "affiliation": "Y",
            "affiliationName": "Graham Hospital Association",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "180 S Main St",
            "city": "Canton",
            "state": "IL",
            "country_code": "US",
            "postal_code": "615202608",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tazwood Mental Health Center, Inc. (Tazwood Center for Wellness)
• Aaron James Thum, D.M.D.
• Amanda Mae Tompkins
• Megan Ann Vallas, MS, RDN, LDN
• Taylor Vaughn, LCPC
• Walgreen Co (Walgreens #9920)
• Walgreen Co. (Walgreens #9920)
• Vicki Walker
• Mary Wallace
• Walmart Inc.

• Family Nurse Practitioner in Canton, IL
• Providers in Canton, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2021; 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.