Rebecca Anne Wagner, MSN RN PMHNP BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

2025063408 Issued in AL

Practice address

4040 Memorial Pkwy SW
Huntsville, AL 35802-4364

Phone

(256) 705-6444

NPI assigned

Feb 23, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AL

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, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

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.

• Wellstone, Inc.

  • Mental Health Counselor
  • Huntsville, AL
  • NPI 1407809213
  Medicare reassignment NPD

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

{
    "created_epoch": "1708646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766361600000",
    "number": "1407612708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4040 MEMORIAL PKWY SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358024364",
            "telephone_number": "256-533-1970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4040 MEMORIAL PKWY SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358024364",
            "telephone_number": "256-705-6444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "REBECCA",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "MSN RN PMHNP BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-23",
        "last_updated": "2025-12-22",
        "certification_date": "2025-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AL",
            "license": "1-180194",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AL",
            "license": "2025063408",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "330000014",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heather Wadsworth, PH.D.
• Lindsay M Waggoner, CRNA
• Deborah Jean Wagner, CRNP
• Francis M. Wagner, CRNA
• Jordyn H Wagner, OT
• Valerie Layne Wagner
• Joy Wagoner
• George B Waites, DMD
• Victor Reed Wakefield Jr., DC
• Wal-Mart Stores East LP

• Psychiatric/Mental Health Nurse Practitioner in Huntsville, AL
• Providers in Huntsville, AL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2025; 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.