Individual provider Active NPI

Sarah Wagner, APN

  • Family Nurse Practitioner
  • Valparaiso, IN
National Provider Identifier
1356841910
Registry record updated Feb 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71007887A Issued in IN
Practice address
2307 Laporte Ave Ste 8
Valparaiso, IN 46383-6997
Phone
(219) 464-7073
Fax
(219) 464-7543
NPI assigned
Feb 20, 2018
Last updated
Feb 24, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 28223493A IN
Family Nurse Practitioner 363LF0000X 71007887A IN Primary

Addresses

Primary practice location

2307 Laporte Ave Ste 8
Valparaiso, IN 46383-6997

Mailing address

PO Box 781076
Detroit, MI 48278-1076
Phone (317) 528-4800

Other practice location 1

8345 Wicker Ave
Saint John, IN 46373-8879
Phone (219) 365-5577

Other practice location 2

1225 E Coolspring Ave
Michigan City, IN 46360-6312
Phone (219) 873-2919

Other identifiers 1

IdentifierTypeStateIssuer
300012545MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address swagner105394@Direct.FranciscanAlliance.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20180417001313 IN Practitioner - Nurse Practitioner 2264795616 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Physician NetworkGroup PAC ID 3072790682, 1,152 clinicians

Practice addresses (Care Compare)

1225 E Coolspring Ave
Michigan City, IN 46360-6312
Phone (219) 879-6531

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
28223493AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Physician Network CurrentSince Apr 5, 2018 Accepting new patients
Franciscan Physician Network CurrentSince Apr 5, 2018 Accepting new patients

Locations

1704 Lafayette Rd
Ste 4
Crawfordsvlle, IN 47933
Phone (765) 364-3120

12800 Mississippi Pkwy
Ste B100
Crown Point, IN 46307
Phone (219) 662-5700

1225 E Coolspring Ave
Michigan City, IN 46360
Phone (219) 873-2919

8345 Wicker Ave
Saint John, IN 46373
Phone (219) 365-5577

150 W Washington St
Shelbyville, IN 46176
Phone (317) 392-3211

2307 Laporte Ave
Ste 8
Valparaiso, IN 46383
Phone (219) 464-7073

Interoperability endpoints

  • Direct secure messaging: swagner105394@direct.franciscanalliance.org

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1519084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677196800000",
    "number": "1356841910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781076",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482781076",
            "telephone_number": "317-528-4800",
            "fax_number": "317-865-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2307 LAPORTE AVE STE 8",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463836997",
            "telephone_number": "219-464-7073",
            "fax_number": "219-464-7543"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8345 Wicker Ave",
            "address_purpose": "LOCATION",
            "city": "Saint John",
            "state": "IN",
            "postal_code": "463738879",
            "country_code": "US",
            "telephone_number": "219-365-5577",
            "fax_number": "219-365-9037",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1225 E Coolspring Ave",
            "address_purpose": "LOCATION",
            "city": "Michigan City",
            "state": "IN",
            "postal_code": "463606312",
            "country_code": "US",
            "telephone_number": "219-873-2919",
            "fax_number": "219-873-2909",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "SARAH",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-20",
        "last_updated": "2023-02-24",
        "certification_date": "2023-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28223493A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71007887A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300012545",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "swagner105394@Direct.FranciscanAlliance.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2307 LaPorte Ave Ste 8",
            "city": "Valparaiso",
            "state": "IN",
            "country_code": "US",
            "postal_code": "463836997",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Valparaiso, IN

Sources for this page

Verify at the official NPI Registry.