Cam Tu Ho Wagner, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5013081 Issued in NC

Practice address

436 Airport Rd Ste 20
Arden, NC 28704-8403

Phone

(407) 200-2352

Fax

(407) 200-1360

NPI assigned

Jul 20, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in FL, NC2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Adventist Health System Sunbelt, Inc.Group PAC ID 6406849256, 212 clinicians

Fletcher Hospital IncGroup PAC ID 5395658819, 302 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cwagner74005@adventhealth.direct-ci.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.

• Fletcher Hospital Inc.

  • Rural Acute Care Hospital
  • Hendersonville, NC
  • NPI 1427075027
  Medicare reassignment Care Compare group NPD
• Adventist Health System Sunbelt, Inc.

  • Urgent Care Clinic/Center
  • Maitland, FL
  • NPI 1073565610

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Urgent Care Centers of Brevard County LLC

  • Urgent Care Clinic/Center
  • Maitland, FL
  • NPI 1295367290

  Family Medicine

  Medicare reassignment NPD
• Fletcher Hospital Inc

  • Rural Health Clinic/Center
  • Saluda, NC
  • NPI 1376371880

  Family Medicine

  NPD
• Fletcher Hospital Inc.

  • Family Medicine Physician
  • Hendersonville, NC
  • NPI 1477995124
  NPD
• Adventist Health System/ Sunbelt, Inc.

  • Urgent Care Clinic/Center
  • The Villages, FL
  • NPI 1396605440

  Family Medicine

  NPD
• Urgent Care Centers of Brevard County LLC

  • Urgent Care Clinic/Center
  • Cocoa Beach, FL
  • NPI 1083246334

  Family Medicine

  NPD
• Urgent Care Centers of Brevard County LLC

  • Urgent Care Clinic/Center
  • Melbourne, FL
  • NPI 1801594858

  Family Medicine

  NPD

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

{
    "created_epoch": "1342742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676851200000",
    "number": "1407101884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 WESTHALL LN STE 300",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327517107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "436 AIRPORT RD STE 20",
            "city": "ARDEN",
            "state": "NC",
            "postal_code": "287048403",
            "telephone_number": "407-200-2352",
            "fax_number": "407-200-1360"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5800 Santa Rosa Rd Ste 149",
            "address_purpose": "LOCATION",
            "city": "Camarillo",
            "state": "CA",
            "postal_code": "930127061",
            "country_code": "US",
            "telephone_number": "805-465-8900",
            "fax_number": "805-465-8920",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "CAM",
        "middle_name": "TU HO",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-20",
        "last_updated": "2023-02-20",
        "certification_date": "2023-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "5013081",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60282469",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11000163",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95006520",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5013081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carolne Tye, PHARMD
• Christopher Ryan Urban, M.D.
• Miguel Angel Velez III, DMD
• Abby Vinyard
• Vista Family Health PA
• Wal-Mart Stores East LP
• Walgreen Co
• Antoinette Wilkes Wall, MD
• Thomas Patrick Wall, LCAS
• Roger A Wallace, MA

• Family Nurse Practitioner in Arden, NC
• Providers in Arden, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2023; 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.