Sophia Collette Wagner

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

226793 Issued in LA

Practice address

4320 Houma Blvd FL 5
Metairie, LA 70006-2961

Phone

(504) 503-6565

Fax

(504) 456-8053

NPI assigned

Jul 25, 2022

Last updated

Sep 15, 2022By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in LA

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, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

East Jefferson Physicians Group LLCGroup PAC ID 4587660402, 211 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• East Jefferson General Hospital Hospital, Metairie, LA, CCN 190176
• West Jefferson Medical Center Hospital, Marrero, LA, CCN 190039

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• East Jefferson Physicians Group LLC

  • Internal Medicine Physician
  • New Orleans, LA
  • NPI 1922293372
  Medicare reassignment Care Compare group NPD
• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  LA, Nurse Practitioner

  Medicare reassignment NPD
• East Jefferson Physicians Group Urgent Care

  • Urgent Care Clinic/Center
  • Kenner, LA
  • NPI 1053859082
  NPD
• Metairie Physician Services Inc.

  • Internal Medicine Physician
  • Metairie, LA
  • NPI 1801233648

  Nurse Practitioner

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• University Healthcare System, L.C.

  • Ambulance
  • Metairie, LA
  • NPI 1023717683

  Hospital

  Care Compare affiliation
• University Healthcare System, L.C.

  • General Acute Care Hospital
  • New Orleans, LA
  • NPI 1033611454
  Care Compare affiliation
• University Healthcare System, L.C.

  dba East Jefferson General Hospital

  • General Acute Care Hospital
  • Metairie, LA
  • NPI 1497792527
  Care Compare affiliation
• University Healthcare System, L.C.

  dba Lakeview Regional Behavioral Health

  • Psychiatric Hospital Unit
  • Covington, LA
  • NPI 1790722825
  Care Compare affiliation
• West Jefferson Holdings, LLC

  dba West Jefferson Medical Center

  • General Acute Care Hospital
  • Marrero, LA
  • NPI 1265437644
  Care Compare affiliation

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

{
    "created_epoch": "1658707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663200000000",
    "number": "1417683277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 HOUMA BLVD",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700062970",
            "telephone_number": "504-503-6781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4320 HOUMA BLVD FL 5",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700062961",
            "telephone_number": "504-503-6565",
            "fax_number": "504-456-8053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "SOPHIA",
        "middle_name": "COLLETTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-25",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "226793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bonita Waesche, CRNA
• Bryan Wagar, RN, BSN
• Michelle Marie Waghorne, LCSW
• Joseph Michael Wagner, LPC-S
• L. David Wagner, MED
• Waguespack Chiropractic
• Katelyn Nichole Waguespack
• Roland Waguespack, M.D.
• Marcelle Gundlach Wainer, AUD
• Jacqueline Waizenegger

• Family Nurse Practitioner in Metairie, LA
• Providers in Metairie, LA by specialty
• Family Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2022; 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.