Active NPI
Julie C Wagner, D.O.
- Family Medicine Physician
- Mt Pleasant, IA
National Provider Identifier
1154385151
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 3661
- Practice address
- 501 S White St
Suite 1
Mt Pleasant, IA 52641-2600 - Phone
- (319) 385-6700
- Fax
- (319) 385-6703
- NPI assigned
- Apr 14, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 3661 | IA | Primary |
Addresses
Primary practice location
501 S White St
Suite 1
Mt Pleasant, IA 52641-2600
Mailing address
501 S White St
Suite 1
Mt Pleasant, IA 52641-2600
Phone (319) 385-6700
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2451757 | Medicaid | IA | |
| 0451757 | Medicaid | IA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060315000774 | IA | Practitioner - Family Practice | 0446267413 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Des Moines University of Osteopathic Medicine and Health Sciences, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Family Medicine of Mt. Pleasant, P.C.
Practice addresses (Care Compare)
501 S White St
Suite 1
Mount Pleasant, IA 52641-2600
Phone (319) 385-6700
Hospital & facility affiliations
- Southeast Iowa Regional Home Health
- Everystep
- Henry County Health Center
- Southeast Iowa Regional Medical Center
- Park Place
Merit-based Incentive Payment System (MIPS)
- Final score
- 96.57 of 100
- Quality
- 100
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 88.57
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
| Removal of skin lesions | 47 |
| Removal or shaving of skin growth | 1-10 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3661 | IA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eastern Iowa Health Center | Family Medicine | Past | Accepting new patients |
| Mercy Medical Center | Past | Accepting new patients | |
| Gibson Community Hospital Association | Past | Accepting new patients |
Organizations & group practices 4
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.
-
- Family Medicine Physician
- Cedar Rapids, IA
- NPI 1578753703
Family Medicine
-
- Psychiatry Physician
- Cedar Rapids, IA
- NPI 1700834165
-
- Critical Access Hospital
- Gibson City, IL
- NPI 1114935681
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Mount Pleasant, IA
- NPI 1811571417
Hospital
-
- Skilled Nursing Facility
- Mount Pleasant, IA
- NPI 1982691002
Nursing home
-
- General Acute Care Hospital
- West Burlington, IA
- NPI 1134168263
Hospital
-
- Home Health Agency
- West Burlington, IA
- NPI 1760461644
-
- Community Based Hospice Care Agency
- Mount Pleasant, IA
- NPI 1285197160
Hospice
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144972800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1192147200000",
"number": "1154385151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "501 S WHITE ST",
"address_2": "SUITE 1",
"city": "MT PLEASANT",
"state": "IA",
"postal_code": "526412600",
"telephone_number": "319-385-6700",
"fax_number": "319-385-6703"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 S WHITE ST",
"address_2": "SUITE 1",
"city": "MT PLEASANT",
"state": "IA",
"postal_code": "526412600",
"telephone_number": "319-385-6700",
"fax_number": "319-385-6703"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGNER",
"first_name": "JULIE",
"middle_name": "C",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-14",
"last_updated": "2007-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IA",
"license": "3661",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2451757",
"state": "IA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0451757",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mt Pleasant, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2007; 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.