Individual provider Active NPI

Muna Elizabeth Wagner, FNP

  • Nurse Practitioner
  • Dalton, GA
National Provider Identifier
1497894133
Registry record updated Nov 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN-NP155078 Issued in GA
Practice address
1200 Memorial Dr
Dalton, GA 30720-2529
Phone
(844) 724-4673
Fax
(706) 217-2054
NPI assigned
Feb 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2025

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 RN155078NP GA
Nurse Practitioner 363L00000X APRN-NP155078 GA Primary

Addresses

Primary practice location

1200 Memorial Dr
Dalton, GA 30720-2529

Mailing address

203 Forrest Park Rd
Dalton, GA 30721
Phone (706) 259-3712

Other practice location 1

4441 Atlanta Rd SE Ste 216
Smyrna, GA 30080-6442
Phone (470) 956-4120

Other practice location 2

1413 Chattanooga Ave
Dalton, GA 30720-2631
Phone (706) 279-2635

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mwagner578555@directwellstar.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20091106000415 GA Practitioner - Nurse Practitioner 2961540208 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hamilton Medical Center, IncGroup PAC ID 0446151179, 105 clinicians

Practice addresses (Care Compare)

1200 Memorial Dr
Dalton, GA 30720-2529
Phone (706) 272-6000

Hospital & facility affiliations

  • Hamilton Medical Center Hospital, Dalton, GA, CCN 110001

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN-NP155078GAMDNurse Practitioner
RN155078NPGAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC CurrentSince Sep 1, 2024 Accepting new patients
Hamilton Physician Group Inc CurrentSince Mar 17, 2025 Accepting new patients
Hamilton Medical Center, Inc. CurrentSince Mar 17, 2025 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients

Locations

1200 Memorial Dr
Dalton, GA 30720
Phone (706) 272-6115

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

4441 Atlanta Rd SE
Ste 216
Smyrna, GA 30080
Phone (470) 956-4120

Interoperability endpoints

  • Direct secure messaging: mwagner47646@hhcs.direct-ci.com

Organizations & group practices 4

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.

Hospital & facility affiliations 3

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": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762214400000",
    "number": "1497894133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 FORREST PARK RD",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "30721",
            "telephone_number": "706-259-3712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 MEMORIAL DR",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307202529",
            "telephone_number": "844-724-4673",
            "fax_number": "706-217-2054"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4441 Atlanta Rd SE Ste 216",
            "address_purpose": "LOCATION",
            "city": "Smyrna",
            "state": "GA",
            "postal_code": "300806442",
            "country_code": "US",
            "telephone_number": "470-956-4120",
            "fax_number": "678-842-5535",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1413 CHATTANOOGA AVE",
            "address_purpose": "LOCATION",
            "city": "Dalton",
            "state": "GA",
            "postal_code": "307202631",
            "country_code": "US",
            "telephone_number": "706-279-2635",
            "fax_number": "706-279-2679",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "MUNA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-06",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN155078NP",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "APRN-NP155078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mwagner578555@directwellstar.org",
            "affiliation": "N",
            "address_1": "4441 Atlanta Rd SE Ste 216",
            "city": "Smyrna",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300806442",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dalton, GA

Sources for this page

Verify at the official NPI Registry.