Individual provider Active NPI

John David Wagner, MD

  • Pediatric Cardiology Physician
  • Atlanta, GA
National Provider Identifier
1144789298
Registry record updated Jul 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
91568 Issued in GA
Practice address
2970 Brandywine Rd Ste 125
Atlanta, GA 30341-5528
Phone
(713) 790-9401
NPI assigned
Mar 18, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X 91568 GA Primary

Addresses

Primary practice location

2970 Brandywine Rd Ste 125
Atlanta, GA 30341-5528

Mailing address

2835 Brandywine Rd Ste 400
Atlanta, GA 30341-5540

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250529002934 GA Practitioner - Pediatric MedicinePractitioner - Cardiovascular Disease (Cardiology) 6305233180 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Medical Care Foundation Inc CurrentSince Jul 1, 2025 Accepting new patients
Childrens Healthcare of Atlanta Cardiology Inc Pediatric Cardiology CurrentSince May 5, 2025 Accepting new patients
Emory Medical Care Foundation Inc CurrentSince Jul 1, 2025 Accepting new patients

Locations

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

2201 Henderson Mill Rd NE
Ste 160
Atlanta, GA 30345
Phone (404) 251-2193

2970 Brandywine Rd
Ste 125
Atlanta, GA 30341
Phone (713) 790-9401

60 Executive Park South NE
Atlanta, GA 30329

2835 Brandywine Rd
Ste 400
Atlanta, GA 30341

2220 N Druid Hills Rd NE
Brookhaven, GA 30329
Phone (404) 778-1440

134 Riverstone Ter
Ste 202
Canton, GA 30114
Phone (770) 213-8942

355 Tower Rd NE
Ste 204
Marietta, GA 30060

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1552867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752710400000",
    "number": "1144789298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2835 BRANDYWINE RD STE 400",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303415540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2970 BRANDYWINE RD STE 125",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303415528",
            "telephone_number": "713-790-9401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "JOHN",
        "middle_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-18",
        "last_updated": "2025-07-17",
        "certification_date": "2025-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "GA",
            "license": "91568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.