Amanda K. Wagner, APRN.CNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

COA.11911-NP Issued in OH

Practice address

2050 Kenny Rd
Columbus, OH 43221-3502

Phone

(614) 293-6529

Fax

(614) 293-9469

NPI assigned

Sep 21, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH

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, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Osu Internal Medicine LLCGroup PAC ID 5496651408, 1,141 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• James Cancer Hospital & Solove Research Institute Hospital, Columbus, OH, CCN 360242
• Ohio State University State Health System Hospital, Columbus, OH, CCN 360085

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: awagner7558@direct.osumc.edu

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.

• Osu Internal Medicine, LLC

  • Internal Medicine Physician
  • Columbus, OH
  • NPI 1740231448
  Medicare reassignment Care Compare group NPD
• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

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

• Arthur G James Cancer Hospital and Research Institute

  • Special Hospital
  • Columbus, OH
  • NPI 1124127683
  Care Compare affiliation
• Ohio State University Hospitals

  • Rehabilitation Hospital Unit
  • Columbus, OH
  • NPI 1184723637
  Care Compare affiliation
• Ohio State University Hospitals

  • General Acute Care Hospital
  • Columbus, OH
  • NPI 1447359997
  Care Compare affiliation
• Ohio State University Hospitals

  • Psychiatric Hospital Unit
  • Columbus, OH
  • NPI 1790876183
  Care Compare affiliation

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

{
    "created_epoch": "1285027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607904000000",
    "number": "1356659668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ACKERMAN RD STE 2120",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021559",
            "telephone_number": "614-293-6529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 KENNY RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432213502",
            "telephone_number": "614-293-6529",
            "fax_number": "614-293-9469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "AMANDA",
        "middle_name": "K.",
        "credential": "APRN.CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-21",
        "last_updated": "2020-12-14",
        "certification_date": "2020-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "APRN.CNP.11911",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "COA.11911-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3128636",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "awagner7558@direct.osumc.edu",
            "affiliation": "N",
            "address_1": "2050 Kenny Rd",
            "city": "Columbus",
            "state": "OH",
            "country_code": "US",
            "postal_code": "432213502",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Gretchen Lynnette Waggoner, AU.D.
• Bivek Wagle
• Deepu Wagle, MD
• Sharon Wagner-Smith, LISW-S
• Alana S. Wagner, APRN-CNP
• Andrea S Wagner, CPNP-PC
• Barlow Reed Wagner
• Cassandra Sue Wagner, SWT BA
• Catherine Grace Wagner
• Colette Wagner

• Adult Health Nurse Practitioner in Columbus, OH
• Providers in Columbus, OH by specialty
• Adult Health Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2020; 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.