NPIMap

Individual provider Active NPI

Michele Wagoner, CRNP

  • Family Nurse Practitioner
  • Cumberland, MD
National Provider Identifier
1407973894
Registry record updated Jul 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R144825 Issued in MD
Practice address
1050 W Industrial Blvd Ste 17
Cumberland, MD 21502-4331
Phone
(240) 964-9300
Fax
(240) 964-9310
NPI assigned
Mar 23, 2007
Last updated
Jul 27, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2020

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 65656 WV
Family Nurse Practitioner 363LF0000X R144825 MD Primary

Addresses

Primary practice location

1050 W Industrial Blvd Ste 17
Cumberland, MD 21502-4331

Mailing address

PO Box 1671
Cumberland, MD 21501-1671
Phone (240) 964-8342

Other practice location 1

23789 Garrett Hwy
Mc Henry, MD 21541-1338
Phone (240) 488-4139

Other practice location 2

10701 New Georges Creek Rd SW
Frostburg, MD 21532-1457
Phone (301) 689-3229

Other names 1

  • Ms. Michele Shekey Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20071005000372 DC Practitioner - Nurse Practitioner 7315032026 Reassigns benefits to 1 organization
I20081209000698 MD Practitioner - Nurse Practitioner 7315032026 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Usacs Integrated Acute Care Services of Maryland LLCGroup PAC ID 4486900172, 178 clinicians

Practice addresses (Care Compare)

12500 Willowbrook Rd
Cumberland, MD 21502-6393
Phone (240) 964-5623

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Upmc Western Maryland Health Services, LLC CurrentSince Jan 1, 2023 Accepting new patients
Transitioncare LLC CurrentSince May 1, 2022 Accepting new patients
Transitioncare LLC Current Accepting new patients
Upmc Western Maryland Health Services, LLC CurrentSince Jan 1, 2023 Accepting new patients
Upmc Western Maryland Corporation CurrentSince Jul 27, 2020 Accepting new patients
Mep Health, LLC CurrentSince Nov 1, 2008 Accepting new patients
Upmc Western Maryland Corporation CurrentSince Jul 27, 2020 Accepting new patients
Upmc Western Maryland Corporation Current Accepting new patients
Usacs Integrated Acute Care Services of Maryland, LLC CurrentSince May 1, 2020 Accepting new patients
Upmc Western Maryland Health Services, LLC Current Accepting new patients
Transitioncare LLC CurrentSince May 1, 2022 Accepting new patients
United Physicians Care Inc Past Accepting new patients
Upmc Western Maryland Corporation Past Accepting new patients
Upmc Western Maryland Corporation Past Accepting new patients
Silver Spring Emergency Physicians, P.C. Past Accepting new patients

Locations

2000 W Baltimore St
Baltimore, MD 21223
Phone (410) 362-3075

10301 Christie Rd NE
Cumberland, MD 21502
Phone (301) 724-1400

12500 Willowbrook Rd
Cumberland, MD 21502
Phone (240) 964-1255

1050 W Industrial Blvd
Ste 17
Cumberland, MD 21502
Phone (240) 964-9300

10701 New Georges Creek Rd SW
Frostburg, MD 21532
Phone (301) 689-2941

1313 National Hwy
Lavale, MD 21502
Phone (240) 362-0288

23789 Garrett Hwy
Mc Henry, MD 21541
Phone (240) 488-4139

5401 Old Court Rd
Randallstown, MD 21133
Phone (301) 337-2727

1500 Forest Glen Rd
Silver Spring, MD 20910
Phone (301) 754-7230

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 5

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": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595808000000",
    "number": "1407973894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1671",
            "city": "CUMBERLAND",
            "state": "MD",
            "postal_code": "215011671",
            "telephone_number": "240-964-8342",
            "fax_number": "240-964-8337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 W INDUSTRIAL BLVD STE 17",
            "city": "CUMBERLAND",
            "state": "MD",
            "postal_code": "215024331",
            "telephone_number": "240-964-9300",
            "fax_number": "240-964-9310"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "23789 Garrett Hwy",
            "address_purpose": "LOCATION",
            "city": "Mc Henry",
            "state": "MD",
            "postal_code": "215411338",
            "country_code": "US",
            "telephone_number": "240-488-4139",
            "fax_number": "240-488-4956",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10701 New Georges Creek Rd SW",
            "address_purpose": "LOCATION",
            "city": "Frostburg",
            "state": "MD",
            "postal_code": "215321457",
            "country_code": "US",
            "telephone_number": "301-689-3229",
            "fax_number": "301-689-1129",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAGONER",
        "first_name": "MICHELE",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-23",
        "last_updated": "2020-07-27",
        "certification_date": "2020-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "65656",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R144825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELE",
            "last_name": "SHEKEY",
            "prefix": "MS.",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cumberland, MD

Sources for this page

Verify at the official NPI Registry.