Active NPI
Brittany Lee Wagner
- Family Nurse Practitioner
- Lexington, KY
National Provider Identifier
1508377151
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 3011621
- Practice address
- 2250 Leestown Rd
Lexington, KY 40511-1052 - Phone
- (859) 233-4511
- NPI assigned
- Oct 22, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 3011621 | KY | Primary |
Addresses
Primary practice location
2250 Leestown Rd
Lexington, KY 40511-1052
Mailing address
1236 Arlington Dr
Paris, KY 40361-2236
Phone (606) 261-5419
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230518000451 | KY | Order and Referring Only - Nurse Practitioner | 9537525472 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1508630400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1555632000000",
"number": "1508377151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1236 ARLINGTON DR",
"city": "PARIS",
"state": "KY",
"postal_code": "403612236",
"telephone_number": "606-261-5419"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2250 LEESTOWN RD",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405111052",
"telephone_number": "859-233-4511"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGNER",
"first_name": "BRITTANY",
"middle_name": "LEE",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-10-22",
"last_updated": "2019-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "KY",
"license": "3011621",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lexington, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2019; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.