Casey Wagner, M.D.

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

E9863 Issued in AR

Practice address

7813 Spivey Station Blvd Ste 220
Jonesboro, GA 30236

Phone

(404) 778-3350

NPI assigned

Jun 15, 2012

Last updated

Aug 12, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Family Practice

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Emory Clinic IncGroup PAC ID 8820901408, 3,507 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Emory Johns Creek Hospital Hospital, Johns Creek, GA, CCN 110230
• Emory University Hospital Hospital, Atlanta, GA, CCN 110010
• Saint Joseph's Hospital of Atlanta, Inc Hospital, Atlanta, GA, CCN 110082
• Wellstar Windy Hill Hospital Long-term care hospital, Marietta, GA, CCN 112007

Merit-based Incentive Payment System (MIPS)

Final score

94.51 of 100Reported as apm

Quality

80.61

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cwagner57001@direct.emory.org

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.

• The Emory Clinic Inc

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1396798229
  Medicare reassignment Care Compare group NPD
• Emory Health Care

  • Neurology Physician
  • Atlanta, GA
  • NPI 1376642751
  NPD (past)
• Southlake Ambulatory Surgery Center, LLLP

  dba Spivey Station Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Jonesboro, GA
  • NPI 1508974353
  NPD (past)

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

• Ehca Johns Creek, LLC

  dba Emory Johns Creek Hospital

  • General Acute Care Hospital
  • Johns Creek, GA
  • NPI 1679632137
  Care Compare affiliation
• Emory University

  dba Emory University Hospital

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1588640692
  Care Compare affiliation
• Emory University

  dba Emory University Hospital At Wesley Woods

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1770560294
  Care Compare affiliation
• Kennestone Hospital, Inc.

  dba Wellstar Windy Hill Hospital

  • Long Term Care Hospital
  • Marietta, GA
  • NPI 1700853041

  Long-term care hospital

  Care Compare affiliation
• Saint Josephs Hospital of Atlanta Inc

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1679664395
  Care Compare affiliation

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

{
    "created_epoch": "1339718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565568000000",
    "number": "1306108279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7813 SPIVEY STATION BLVD STE 220",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302362900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7813 SPIVEY STATION BLVD STE 220",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "30236",
            "telephone_number": "404-778-3350"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1364 Clifton Rd NE",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303221064",
            "country_code": "US",
            "telephone_number": "404-712-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3900 N Parkview Dr",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "AR",
            "postal_code": "727036398",
            "country_code": "US",
            "telephone_number": "479-966-4187",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3900 N Parkview Dr",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "AR",
            "postal_code": "727036398",
            "country_code": "US",
            "telephone_number": "479-966-4187",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "CASEY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-15",
        "last_updated": "2019-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "GA",
            "license": "82480",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "AR",
            "license": "E9863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vladimyr Hilaire
• Diem-Anh Vo, MD
• Kimberley Vrana
• Nhu Vu
• Michael Meyer Vuocolo, D.D.S
• Freddie James Wakefield Jr., DMD
• Walgreen Co (Rite Aid #11768)
• Walgreen Co (Walgreens #09271)
• Alea Walker
• Brian Scott Walker, DPT

• Sports Medicine (Family Medicine) Physician in Jonesboro, GA
• Providers in Jonesboro, GA by specialty
• Sports Medicine (Family Medicine) Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2019; 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.