NPIMap

Individual provider Active NPI

John P Wagner, DO

  • Family Medicine Physician
  • Stow, OH
National Provider Identifier
1104869080
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34004138 Issued in OH
Practice address
4465 Darrow Rd
Stow, OH 44224-1884
Phone
(330) 688-9918
Fax
(330) 688-4718
NPI assigned
Jun 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 34004138 OH Primary

Addresses

Primary practice location

4465 Darrow Rd
Stow, OH 44224-1884

Mailing address

4465 Darrow Rd
Stow, OH 44224-1884
Phone (330) 688-9918

Other identifiers 1

IdentifierTypeStateIssuer
0722427MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060124000869 OH Practitioner - Family Practice 1658395017 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
86.67 of 100Reported as group
Quality
77.19
Promoting interoperability
100
Improvement activities
40
Cost
78.37

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Unity Health Network, LLC CurrentSince Dec 1, 2009 Accepting new patients
Unity Health Network, LLC Family Medicine CurrentSince Dec 1, 2009 Accepting new patients
Buckeye Forest at Canton LLC Past Accepting new patients
Aj Kent Care Center Opco LLC Past Accepting new patients
Continuing Healthcare of Cuyahoga Falls, LLC Past Accepting new patients
Embassy Longmeadow LLC Past Accepting new patients
Hudson Elms Opco, LLC Past Accepting new patients
Seasons Healthcare Group, LLC Past Accepting new patients
Progressive Green Meadows, LLC Past Accepting new patients
Bath Creek Healthcare Group, Inc. Past Accepting new patients
FHS Brimfield, Inc. Past Accepting new patients
Kent Oh Health & Rehab Opco LLC Past Accepting new patients
St. Edward Home Past Accepting new patients

Locations

1900 23rd St
Cuyahoga Fls, OH 44223
Phone (330) 929-2685

3033 State Rd
Ste 204
Cuyahoga Fls, OH 44223
Phone (330) 253-9727

3033 State Rd
Ste 101
Cuyahoga Fls, OH 44223
Phone (330) 923-8372

4465 Darrow Rd
Stow, OH 44224
Phone (330) 688-9501

Interoperability endpoints

  • Direct secure messaging: john.wagner@wrhs.eclinicaldirectplus.com

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Majestic Care of KentKent, OH, CCN 365834 Skilled nursing facility Managing Control - Governing Body
Adp of the SNF		 Dec 30, 2024
Dec 30, 2024
The Care Team HospiceHighland Heights, OH, CCN 361602 Hospice W-2 Managing Employee Dec 3, 2025

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1104869080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4465 DARROW RD",
            "city": "STOW",
            "state": "OH",
            "postal_code": "442241884",
            "telephone_number": "330-688-9918",
            "fax_number": "330-688-4718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4465 DARROW RD",
            "city": "STOW",
            "state": "OH",
            "postal_code": "442241884",
            "telephone_number": "330-688-9918",
            "fax_number": "330-688-4718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "JOHN",
        "middle_name": "P",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34004138",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0722427",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stow, OH

Sources for this page

Verify at the official NPI Registry.