Savannah Elizabeth Wagoner, FNP-BC
Individual provider Active NPI Family Nurse Practitioner · Berne, NY
NPI 1295433241 · NPPES record last updated Feb 20, 2023
Key facts
- NPI
- 1295433241
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- F351072 (NY)
- Practice address
- 1705 Helderberg Trail
Berne, NY 12023 - Phone
- (518) 872-0009
- NPI assigned
- Feb 20, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230418000958 | NY | Practitioner - Nurse Practitioner | 7113392515 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F351072 | NY | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hilltown Healthcare NP Family PLLC | Current |
Accepting new patients |
Locations
1705 Helderberg Trl
Berne, NY 12023
Phone (518) 872-0009
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | F351072 | NY | Yes |
Addresses
Primary practice location
1705 Helderberg Trail
Berne, NY 12023
Mailing address
1705 Helderberg Trail
Berne, NY 12023
Phone (518) 872-0009
Other providers in Berne, NY
- Britta Hahne Lovegrove
- Jill Marie Martin
- Hope E Salamonowicz
- Margaret Stephens Smith
- Lisa Stansfield
All providers in Berne, NY · Family Nurse Practitioner in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 20, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.