Jennifer Wagner, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

F340629 Issued in NY

Practice address

37 N Chemung St
Waverly, NY 14892-1211

Phone

(607) 565-2861

NPI assigned

Nov 25, 2013

Last updated

Apr 5, 2021By 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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NY, PA2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Guthrie Medical Group PCGroup PAC ID 6002728656, 795 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Robert Packer Hospital Hospital, Sayre, PA, CCN 390079

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jwagner50358@direct-guthrie.org

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.

• Guthrie Medical Group, P.C.

  • Family Medicine Physician
  • Athens, PA
  • NPI 1962451153
  Medicare reassignment Care Compare group NPD
• Guthrie Medical Group, P.C.

  • Multi-Specialty Clinic/Center
  • Corning, NY
  • NPI 1134178635
  Medicare reassignment NPD
• Guthrie Medical Group, LTD.

  • Nephrology Physician
  • Sayre, PA
  • NPI 1063464410
  NPD
• Guthrie Medical Group, P.C.

  • Obstetrics & Gynecology Physician
  • Sayre, PA
  • NPI 1053363408
  NPD
• Guthrie Medical Group, P.C.

  • Rheumatology Physician
  • Sayre, PA
  • NPI 1063464295
  NPD
• Guthrie Medical Group, P.C.

  • General Practice Physician
  • Sayre, PA
  • NPI 1245246644
  NPD
• Guthrie Medical Group, P.C.

  • Gastroenterology Physician
  • Sayre, PA
  • NPI 1336191782
  NPD
• Guthrie Medical Group, P.C.

  • Family Medicine Physician
  • Sayre, PA
  • NPI 1508818733
  NPD
• Guthrie Medical Group, P.C.

  • Orthopaedic Surgery Physician
  • Sayre, PA
  • NPI 1851343206
  NPD
• Guthrie Medical Group, P.C.

  • Ophthalmology Physician
  • Sayre, PA
  • NPI 1962454314
  NPD
• Western New York Med-Psych PLLC

  • Psychiatry Physician
  • Hornell, NY
  • NPI 1891706743
  NPD (past)
• Western New York Med-Psych PLLC

  • Psychiatry Physician
  • Coudersport, PA
  • NPI 1568618353
  NPD (past)

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

• Robert Packer Hospital

  • General Acute Care Hospital
  • Sayre, PA
  • NPI 1083614382
  Care Compare affiliation
• Robert Packer Hospital

  dba Robert Packer Hospital, Towanda Campus

  • General Acute Care Hospital
  • Towanda, PA
  • NPI 1134734528
  Care Compare affiliation

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

{
    "created_epoch": "1385337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617580800000",
    "number": "1508296773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GUTHRIE SQ",
            "city": "SAYRE",
            "state": "PA",
            "postal_code": "188401625",
            "telephone_number": "570-888-5858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 N CHEMUNG ST",
            "city": "WAVERLY",
            "state": "NY",
            "postal_code": "148921211",
            "telephone_number": "607-565-2861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "JENNIFER",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-25",
        "last_updated": "2021-04-05",
        "certification_date": "2021-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F340629",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02693896",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jwagner50358@direct-guthrie.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "37 N Chemung St",
            "city": "Waverly",
            "state": "NY",
            "country_code": "US",
            "postal_code": "148921211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Kristen Vandyke
• Molly Sue Wallace-Welch, RN, BSN
• Patricia Louise Ward, RPT
• Waverly Central School District
• Waverly Medical Associates LLC
• We Play Speech & Physical Therapy Services PLLC

• Nurse Practitioner in Waverly, NY
• Providers in Waverly, NY by specialty
• Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2021; 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.