Ashley C Wagner, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA9105434 Issued in FL

Practice address

350 Redstone Ave W
Crestview, FL 32536-6433

Phone

(850) 689-1740

Fax

(850) 682-6652

NPI assigned

Mar 30, 2009

Last updated

Sep 25, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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 FL

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

Physician Assistant

Education

University of Alabama School of Medicine, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emerald Coast Dermatology and Skin Surgery Center P aGroup PAC ID 7618928318, 7 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Emerald Coast Dermatology & Skin Surgery Center PA

  • Dermatology Physician
  • Crestview, FL
  • NPI 1386639912
  Medicare reassignment Care Compare group
• Orthopaedic Specialists of Alabama PC

  • Orthopaedic Surgery Physician
  • Birmingham, AL
  • NPI 1831133586
  NPD (past)
• Orthopaedic Specialists of Alabama, PC

  • Orthopaedic Surgery Physician
  • Talladega, AL
  • NPI 1275843492
  NPD (past)

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

{
    "created_epoch": "1238371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790294400000",
    "number": "1205078706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 REDSTONE AVE W",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325366433",
            "telephone_number": "850-689-1740",
            "fax_number": "850-682-6652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 REDSTONE AVE W",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325366433",
            "telephone_number": "850-689-1740",
            "fax_number": "850-682-6652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "ASHLEY",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-30",
        "last_updated": "2026-09-25",
        "certification_date": "2026-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9105434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Grace Evasco Vinson, FNP
• Carolyn M Vlass, PT
• Carolyn C Volz, O.T.
• Sarah Vongunten
• W. Michelle Long, LCSW, Professional Limited Liability Company
• Courtney Lee Wagner, LPN
• William Scott Wakefield, MD
• Wal-Mart Stores East LP (Walmart Pharmacy 10-0944)
• Wal-Mart Stores East, LP (Walmart Pharmacy 10-3361)
• Walgreen Co (Walgreens #06811)

• Medical Physician Assistant in Crestview, FL
• Providers in Crestview, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2026; 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.