James Lucas Wagoner, MSN, APRN, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP142434 Issued in TX

Practice address

1023 N Mound St Ste E
Nacogdoches, TX 75961-4453

Phone

(936) 305-4130

Fax

(936) 305-4127

NPI assigned

Jul 30, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wagoner Health Clinic PLLCGroup PAC ID 9638544018, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• A Pineywoods Home Health Care Inc Home health agency, Lufkin, TX, CCN 677545
• Nacogdoches Medical Center Hospital, Nacogdoches, TX, CCN 450656
• Nacogdoches Memorial Hospital Hospital, Nacogdoches, TX, CCN 450508

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: james.wagoner.1@27888.direct.athenahealth.com

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.

• Wagoner Health Clinic, PLLC

  • Primary Care Nurse Practitioner
  • Nacogdoches, TX
  • NPI 1396454484
  Medicare reassignment Care Compare group NPD

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

• A Pineywoods Home Health Care, Inc.

  • Home Health Agency
  • Lufkin, TX
  • NPI 1174638852
  Care Compare affiliation
• Nacogdoches County Hospital District

  • Rural Acute Care Hospital
  • Nacogdoches, TX
  • NPI 1801831748
  Care Compare affiliation
• TH Healthcare, LTD

  • General Acute Care Hospital
  • Nacogdoches, TX
  • NPI 1700885076
  Care Compare affiliation

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

{
    "created_epoch": "1564444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674086400000",
    "number": "1104470988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1023 N MOUND ST STE E",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759614453",
            "telephone_number": "936-305-4130",
            "fax_number": "936-305-4127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1023 N MOUND ST STE E",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759614453",
            "telephone_number": "936-305-4130",
            "fax_number": "936-305-4127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGONER",
        "first_name": "JAMES",
        "middle_name": "LUCAS",
        "name_prefix": "Mr.",
        "credential": "MSN, APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-30",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP142434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kavita S Vyas, M.D.
• Shyam A Vyas, MD
• Kalisha Wade, CCC SLP
• Ladedra Wade
• Wagoner Health Clinic, PLLC
• Rebekah Marie Wagoner, APRN, FNP-C
• Cara Danielle Wagstaff, COTA
• Wal-Mart Stores Texas LLC
• Wal-Mart Stores Texas LLC
• Wal-Mart Stores Texas, LP

• Family Nurse Practitioner in Nacogdoches, TX
• Providers in Nacogdoches, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2023; 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.