Brian George Wagoner, RN, FNP BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

155580 Issued in MO

Practice address

1235 E Cherokee St
Springfield, MO 65804-2203

Phone

(417) 820-9729

Fax

(417) 820-6471

NPI assigned

Jan 12, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

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

Nurse Practitioner

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mercy Clinic Springfield CommunitiesGroup PAC ID 7416865845, 1,121 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital Springfield Hospital, Springfield, MO, CCN 260065

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

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.

• Mercy Clinic Springfield Communities

  • Family Medicine Physician
  • Springfield, MO
  • NPI 1245277631
  Medicare reassignment Care Compare group NPD
• Mercy Clinic Springfield Communities

  • Rural Health Clinic/Center
  • Willow Springs, MO
  • NPI 1972771657

  Family

  NPD
• Ozarks Medical Center

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mercy Hospital Springfield

  • Air Ambulance
  • Branson West, MO
  • NPI 1144430760

  Hospital

  Care Compare affiliation
• Mercy Hospital Springfield

  • Land Ambulance
  • Mount Vernon, MO
  • NPI 1427279173

  Hospital

  Care Compare affiliation
• Mercy Hospital Springfield

  • Land Ambulance
  • Camdenton, MO
  • NPI 1477765204

  Hospital

  Care Compare affiliation
• Mercy Hospital Springfield

  • Land Ambulance
  • Winona, MO
  • NPI 1538380654

  Hospital

  Care Compare affiliation
• Mercy Hospital Springfield

  • Land Ambulance
  • Stockton, MO
  • NPI 1558573386

  Hospital

  Care Compare affiliation
• Mercy Hospital Springfield

  • Land Ambulance
  • Springfield, MO
  • NPI 1558573410

  Hospital

  Care Compare affiliation
• Mercy Hospital Springfield

  • General Acute Care Hospital
  • Springfield, MO
  • NPI 1578504056
  Care Compare affiliation
• Mercy Hospital Springfield

  • Land Ambulance
  • Mountain View, MO
  • NPI 1639204308

  Hospital

  Care Compare affiliation
• Mercy Hospital Springfield

  • Land Ambulance
  • Green Forest, AR
  • NPI 1477756609

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1231718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244592000000",
    "number": "1306083480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2580",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658012580",
            "telephone_number": "417-829-4620",
            "fax_number": "417-829-4312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 E CHEROKEE ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042203",
            "telephone_number": "417-820-9729",
            "fax_number": "417-820-6471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGONER",
        "first_name": "BRIAN",
        "middle_name": "GEORGE",
        "name_prefix": "Mr.",
        "credential": "RN, FNP BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-12",
        "last_updated": "2009-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "155580",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Caitlyn Jo Wages, DC
• Susan Waggoner, MA
• Armin Jared Wagman, M.D.
• Patricia Wagner, DNP, NP-BC
• Roger Wagner, M.S., CCC-SLP
• Hanna Wagoner, RD
• Shahzad Bin Waheed, MD
• Alexandra Mercedes Wahler
• Savanna R Waite, PLPC
• John A Waites, MD

• Family Nurse Practitioner in Springfield, MO
• Providers in Springfield, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2009; 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.