Katherine Leigh Wagner, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

1999137599 Issued in MO

Practice address

405 Main St
Hillsboro, MO 63050-4351

Phone

(636) 797-3737

Fax

(636) 481-2100

NPI assigned

Jul 3, 2006

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 names 1

• Katherine Hammer Former name

Electronic endpoints 2

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: katherine.wagner@direct.signature.nextgenshare.com

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.

• Physician Groups LC

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1285664268
  Medicare reassignment NPD
• Jefferson County Health Department

  • Public Health or Welfare Agency
  • Hillsboro, MO
  • NPI 1235118324
  Medicare reassignment
• Physician Groups LC

  • Multi-Specialty Clinic/Center
  • Farmington, MO
  • NPI 1427114990
  NPD
• Compass Health, Inc

  • Federally Qualified Health Center (FQHC)
  • High Ridge, MO
  • NPI 1356751648
  NPD (past)
• Jefferson County Health Departmet

  • Public Health or Welfare Agency
  • Arnold, MO
  • NPI 1093856163
  NPD (past)

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636934400000",
    "number": "1376573923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3023 N BALLAS RD STE 600D",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312332",
            "telephone_number": "314-567-7018",
            "fax_number": "314-567-7048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 MAIN ST",
            "city": "HILLSBORO",
            "state": "MO",
            "postal_code": "630504351",
            "telephone_number": "636-797-3737",
            "fax_number": "636-481-2100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1818 Lonedell Rd",
            "address_purpose": "LOCATION",
            "city": "Arnold",
            "state": "MO",
            "postal_code": "630101050",
            "country_code": "US",
            "telephone_number": "636-282-1010",
            "fax_number": "636-481-2100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3023 N Ballas Rd Ste 600",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631312332",
            "country_code": "US",
            "telephone_number": "314-567-7018",
            "fax_number": "314-567-7048",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3023 N Ballas Rd Ste 600D",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631312332",
            "country_code": "US",
            "telephone_number": "314-996-4880",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "KATHERINE",
        "middle_name": "LEIGH",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-03",
        "last_updated": "2021-11-15",
        "certification_date": "2021-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "1999137599",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "1999137599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "katherine.wagner@direct.signature.nextgenshare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3023 N Ballas Rd Ste 600",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631312332",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3023 N Ballas Rd Ste 600D",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631312332",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "HAMMER",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jennifer Tucker, LMSW
• Kevin Marcell Turner, DO
• Lisa M Vasel
• Rhonda J Viars, SLP-A
• Ross Vollmer, DC
• Amber Wallenbrock, RN
• Maddesyn Larren Warren
• Tiffany Erin Webster, LCSW
• Joshua White
• Kimberly Dawn Wilson, LPC

• Nurse Practitioner in Hillsboro, MO
• Providers in Hillsboro, MO by specialty
• Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.