NPIMap

Individual provider Active NPI

John H Wagner III, M.D., C.M.D.

  • General Practice Physician
  • Cullman, AL
National Provider Identifier
1487634085
Registry record updated Nov 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
8613 Issued in AL
Practice address
401 Arnold St NE
Cullman, AL 35055-1968
Phone
(256) 739-9593
Fax
(256) 739-2984
NPI assigned
Jan 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 8613 AL Primary

Addresses

Primary practice location

401 Arnold St NE
Cullman, AL 35055-1968

Mailing address

PO Box 339
401 Arnold Street NE
Cullman, AL 35056-0339
Phone (256) 739-9593

Other identifiers 5

IdentifierTypeStateIssuer
051551301OtherALBC/BS OF ALABAMA
009935241MedicaidAL
010066311OtherALMETRA RAILROAD MEDICARE
51027867OtherALBC/BS OF ALABAMA
000027867MedicaidAL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041021000272 AL Practitioner - Family Practice 9133180334 Reassigns benefits to 6 organizations
Practice locations: Moulton, AL

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of South Alabama College of Medicine, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eastern Hospital Medicine PCGroup PAC ID 8325044597, 26 clinicians

Practice addresses (Care Compare)

50 Medical Park E Dr
Birmingham, AL 35235-3401
Phone (205) 838-3000

Hospital & facility affiliations

  • Aveanna Home Health Home health agency, Hoover, AL, CCN 017153
  • Aveanna Hospice of Cullman Hospice, Cullman, AL, CCN 011643
  • Gentiva Huntsville Hospice, Huntsville, AL, CCN 011674
  • Hospice of North Alabama, LLC Hospice, Huntsville, AL, CCN 011622
  • Southerncare New Beacon Scottsboro Hospice, Scottsboro, AL, CCN 011512
  • Cullman Regional Medical Center Hospital, Cullman, AL, CCN 010035
  • Huntsville Hospital Hospital, Huntsville, AL, CCN 010039
  • Decatur Morgan Hospital - Decatur Campus Hospital, Decatur, AL, CCN 010085
  • Brookshire Healthcare Center Nursing home, Huntsville, AL, CCN 015127
  • Cullman Health Care Center Nursing home, Cullman, AL, CCN 015048
  • Folsom Rehabilitation and Healthcare Center Nursing home, Cullman, AL, CCN 015437
  • Decatur Health & Rehab Center Nursing home, Decatur, AL, CCN 015206
  • Rocket City Rehabilitation and Healthcare Center Nursing home, Huntsville, AL, CCN 015116

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
8613ALMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Director Services PC CurrentSince Apr 1, 2025 Accepting new patients
Dermaccel CurrentSince Mar 22, 2024 Accepting new patients
Eastern Hospital Medicine PC CurrentSince Oct 22, 2023 Accepting new patients
Curana Health of Alabama LLC CurrentSince Mar 15, 2023 Accepting new patients
Alabama Mso LLC CurrentSince May 16, 2025 Accepting new patients
Tri- County Mobile X-Ray Inc. CurrentSince Feb 25, 2019 Accepting new patients
Russellville Hospital Inc CurrentSince Aug 6, 2023 Accepting new patients
Russellville Hospital Inc CurrentSince Aug 6, 2023 Accepting new patients
Eastern Hospital Medicine PC CurrentSince Oct 22, 2023 Accepting new patients
Dermaccel PastSince Aug 17, 2025 Accepting new patients
Whitesburg SNF Operations LLC Past Accepting new patients
Decatur SNF Operations LLC Past Accepting new patients
LP Huntsville, LLC Past Accepting new patients
Brookshire SNF Operations LLC Past Accepting new patients
Folsom SNF Operations LLC Past Accepting new patients
Cullman SNF Operations LLC Past Accepting new patients
Northside SNF Operations LLC Past Accepting new patients
Falkville SNF Operations LLC Past Accepting new patients
Woodland SNF Operations LLC Past Accepting new patients

Locations

50 Medical Park Dr E
Birmingham, AL 35235
Phone (205) 838-3000

401 Arnold St NE
Cullman, AL 35055
Phone (256) 739-4409

1 Perimeter Park S
Ste 100N
Mountain Brook, AL 35243
Phone (205) 936-2356

15225 Highway 43
Ste I
Russellville, AL 35653
Phone (256) 331-2700

119 Watterson Pkwy
Trussville, AL 35173
Phone (205) 655-3226

1509 Dulles Dr
Lafayette, LA 70506
Phone (337) 408-0803

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Ownership & related parties

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Brookshire Rehabilitation and Healthcare CenterHuntsville, AL, CCN 015127 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Mar 1, 2023
Mar 1, 2023
Decatur Rehabilitation and Healthcare CenterDecatur, AL, CCN 015206 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Mar 24, 2023
Mar 24, 2023
Cullman Rehabilitation and Healthcare CenterCullman, AL, CCN 015048 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Mar 24, 2023
Mar 24, 2023
Folsom Rehabilitation and Healthcare CenterCullman, AL, CCN 015437 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Mar 24, 2023
Mar 24, 2023
Rocket City Rehabilitation and Healthcare CenterHuntsville, AL, CCN 015116 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Dec 1, 2024
Dec 1, 2024

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 19

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.

View all 19

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257120000000",
    "number": "1487634085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 339",
            "address_2": "401 ARNOLD STREET NE",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "350560339",
            "telephone_number": "256-739-9593",
            "fax_number": "256-739-2984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 ARNOLD ST NE",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "350551968",
            "telephone_number": "256-739-9593",
            "fax_number": "256-739-2984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "JOHN",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D., C.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2009-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "AL",
            "license": "8613",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF ALABAMA",
            "identifier": "051551301",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009935241",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "METRA RAILROAD MEDICARE",
            "identifier": "010066311",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF ALABAMA",
            "identifier": "51027867",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000027867",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cullman, AL

Sources for this page

Verify at the official NPI Registry.