Audrey Anne Wagner, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

76333 Issued in TN

Practice address

601 W Due West Ave
Madison, TN 37115-4423

Phone

(615) 227-3000

NPI assigned

Apr 7, 2021

Last updated

Feb 20, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL, TN2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Family Practice

Education

University of Missouri, Columbia School of Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Lee Health System IncGroup PAC ID 9335672146, 1,381 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lee Memorial Home Health, Inc. Home health agency, Fort Myers, FL, CCN 107191
• Trilogy Home Healthcare Home health agency, Estero, FL, CCN 108173
• Lee Memorial Hospital Hospital, Fort Myers, FL, CCN 100012
• Cape Coral Hospital Hospital, Cape Coral, FL, CCN 100244
• Gulf Coast Medical Center Lee Health Hospital, Fort Myers, FL, CCN 100220

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: awagner301401@direct.leememorial.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.

• Lee Health System Inc

  • Internal Medicine Physician
  • Fort Myers, FL
  • NPI 1942058557

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Lee Memorial Health System

  • Internal Medicine Physician
  • Fort Myers, FL
  • NPI 1992873319

  Family Medicine

  Medicare reassignment NPD
• United Neighborhood Health Services, Inc

  dba UNHS-Unity Clinic Casa

  • Federally Qualified Health Center (FQHC)
  • Nashville, TN
  • NPI 1750723029
  Medicare reassignment
• United Neighborhood Health Services, Inc

  dba Neighborhood Health

  • Federally Qualified Health Center (FQHC)
  • Nashville, TN
  • NPI 1275567588
  NPD
• United Neighborhood Health Services, Inc.

  dba Salvus Center

  • Federally Qualified Health Center (FQHC)
  • Gallatin, TN
  • NPI 1396510228
  NPD
• Lee Health System Inc

  dba Lee Health Specialty Pharmacy

  • Community/Retail Pharmacy
  • Bonita Springs, FL
  • NPI 1699510925
  NPD
• Lee Memorial Health System

  dba LCH-Golisano Peds PC Bayshore

  • Federally Qualified Health Center (FQHC)
  • Port Charlotte, FL
  • NPI 1255171765
  NPD
• Lee Memorial Health System

  dba LCH- Pediatric Ophthalmology

  • Federally Qualified Health Center (FQHC)
  • Fort Myers, FL
  • NPI 1770165920
  NPD

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

• Bridges Home Health Inc.

  dba Trilogy Home Healthcare

  • Home Health Agency
  • Fort Myers, FL
  • NPI 1376517862
  Care Compare affiliation
• Lee Health System Inc

  dba Gulf Coast Medical Center

  • General Acute Care Hospital
  • Fort Myers, FL
  • NPI 1366281750
  Care Compare affiliation
• Lee Health System Inc

  dba Lee Memorial Hospital

  • General Acute Care Hospital
  • Fort Myers, FL
  • NPI 1427806025
  Care Compare affiliation
• Lee Health System Inc

  dba Cape Coral Hospital

  • General Acute Care Hospital
  • Cape Coral, FL
  • NPI 1780429076
  Care Compare affiliation
• Lee Memorial Home Health Inc

  dba Lee Memorial Home Health

  • Home Health Agency
  • Fort Myers, FL
  • NPI 1689672065
  Care Compare affiliation

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

{
    "created_epoch": "1617753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771545600000",
    "number": "1619556388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2711 FOSTER AVE",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372105307",
            "telephone_number": "573-673-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 W DUE WEST AVE",
            "city": "MADISON",
            "state": "TN",
            "postal_code": "371154423",
            "telephone_number": "615-227-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "617 S 8th St",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372063819",
            "country_code": "US",
            "telephone_number": "615-227-3000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2780 Cleveland Ave Ste 709",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339015857",
            "country_code": "US",
            "telephone_number": "239-343-2371",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8960 Colonial Center Dr Ste 300",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339057810",
            "country_code": "US",
            "telephone_number": "239-343-9470",
            "fax_number": "239-343-9498",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "AUDREY",
        "middle_name": "ANNE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-07",
        "last_updated": "2026-02-20",
        "certification_date": "2026-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "76333",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME158286",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "115971600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vital Wound and Foot Care LLC
• Vivian Tuong Vo
• W. Clark Higgs, D.D.S.
• Linda Marie Wade, FNP
• Qadria Wade
• Inice Marie Wagner
• Jacob Bradley Wagner, DNAP
• Leslie Aileen Wagner
• Wal-Mart Stores East LP (Walmart Pharmacy 10-0695)
• Wal-Mart Stores East LP (Walmart Pharmacy 10-5107)

• Family Medicine Physician in Madison, TN
• Providers in Madison, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2026; 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.