Shana Wagner, CPNP-PC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

APRN.CNP.0036642 Issued in OH

Practice address

700 Childrens Dr
Columbus, OH 43205-2639

Phone

(614) 722-2000

NPI assigned

Apr 18, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Nationwide Children'S Hospital

  • Multi-Specialty Clinic/Center
  • Columbus, OH
  • NPI 1851179873

  Pediatrics

  Medicare reassignment NPD
• Nationwide Children'S Hospital

  • Durable Medical Equipment & Medical Supplies
  • Columbus, OH
  • NPI 1447061262
  NPD

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

{
    "created_epoch": "1713398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774828800000",
    "number": "1407601040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 CHILDRENS DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432052664",
            "telephone_number": "614-722-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 CHILDRENS DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432052639",
            "telephone_number": "614-722-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "536 S Trimble Rd",
            "address_purpose": "LOCATION",
            "city": "Mansfield",
            "state": "OH",
            "postal_code": "449063418",
            "country_code": "US",
            "telephone_number": "614-722-6200",
            "fax_number": "614-722-2549",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11 John Lloyd Evans Memorial Dr",
            "address_purpose": "LOCATION",
            "city": "Nelsonville",
            "state": "OH",
            "postal_code": "457642523",
            "country_code": "US",
            "telephone_number": "614-722-6200",
            "fax_number": "614-722-2549",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "26 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Athens",
            "state": "OH",
            "postal_code": "457012471",
            "country_code": "US",
            "telephone_number": "614-722-2200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7901 Diley Rd",
            "address_purpose": "LOCATION",
            "city": "Canal Winchester",
            "state": "OH",
            "postal_code": "431109612",
            "country_code": "US",
            "telephone_number": "614-722-6200",
            "fax_number": "614-722-2549",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5665 Venture Dr",
            "address_purpose": "LOCATION",
            "city": "Dublin",
            "state": "OH",
            "postal_code": "430172159",
            "country_code": "US",
            "telephone_number": "614-722-6200",
            "fax_number": "614-722-2549",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1069 Delaware Ave",
            "address_purpose": "LOCATION",
            "city": "Marion",
            "state": "OH",
            "postal_code": "433021400",
            "country_code": "US",
            "telephone_number": "614-722-6200",
            "fax_number": "614-722-2549",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "830 W High St",
            "address_purpose": "LOCATION",
            "city": "Lima",
            "state": "OH",
            "postal_code": "458013971",
            "country_code": "US",
            "telephone_number": "614-722-6200",
            "fax_number": "614-722-2549",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1818 Chapel Dr",
            "address_purpose": "LOCATION",
            "city": "Findlay",
            "state": "OH",
            "postal_code": "458401335",
            "country_code": "US",
            "telephone_number": "614-722-6200",
            "fax_number": "614-722-2549",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7853 Pacer Dr",
            "address_purpose": "LOCATION",
            "city": "Delaware",
            "state": "OH",
            "postal_code": "430157571",
            "country_code": "US",
            "telephone_number": "614-722-6200",
            "fax_number": "614-722-2549",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Childrens Plz",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454041873",
            "country_code": "US",
            "telephone_number": "614-722-6200",
            "fax_number": "614-722-2549",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4439 State Route 159",
            "address_purpose": "LOCATION",
            "city": "Chillicothe",
            "state": "OH",
            "postal_code": "456018207",
            "country_code": "US",
            "telephone_number": "614-722-6200",
            "fax_number": "614-722-2549",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1711 27th St",
            "address_purpose": "LOCATION",
            "city": "Portsmouth",
            "state": "OH",
            "postal_code": "456622654",
            "country_code": "US",
            "telephone_number": "614-722-6200",
            "fax_number": "614-722-2549",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "455 Executive Campus Dr",
            "address_purpose": "LOCATION",
            "city": "Westerville",
            "state": "OH",
            "postal_code": "430828870",
            "country_code": "US",
            "telephone_number": "614-722-6200",
            "fax_number": "614-722-2549",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "740 Adair Ave",
            "address_purpose": "LOCATION",
            "city": "Zanesville",
            "state": "OH",
            "postal_code": "437012838",
            "country_code": "US",
            "telephone_number": "614-722-6200",
            "fax_number": "614-722-3111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "555 S 18th St",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432052654",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "fax_number": "614-722-3111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "SHANA",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-18",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OH",
            "license": "APRN.CNP.0036642",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0066467",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maddison Wagner, CPNP- PC
• Matthew Gary Wagner
• Matthew M Wagner, MD
• Rebecca Anne Wagner, APRN-CNM
• Samantha Wagner, PHARMD
• Steventon Scott Wagner, DPM
• Tracey Lynn Wagner, M.D.
• Tara S. Wagoner
• Daniel G Wah Jr.
• Shaun Abdul Wahab, M.D.

• Pediatric Nurse Practitioner in Columbus, OH
• Providers in Columbus, OH by specialty
• Pediatric Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2026; 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.