Betty J Wagner, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

71000881A Issued in IN

Practice address

6910 Hillsdale CT
Indianapolis, IN 46250-2040

Phone

(317) 841-6552

Fax

(317) 841-6160

NPI assigned

Jul 20, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Community Hospitals of Indiana Inc

  dba Yerks Family Medicine

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1477576445
  NPD (past)
• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497398400000",
    "number": "1619997731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10215 S 250 W",
            "city": "PENDLETON",
            "state": "IN",
            "postal_code": "460648760",
            "telephone_number": "317-339-6661",
            "fax_number": "765-778-0314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6910 HILLSDALE CT",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502040",
            "telephone_number": "317-841-6552",
            "fax_number": "317-841-6160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "BETTY",
        "middle_name": "J",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2017-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "IN",
            "license": "71000881A",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71000881A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200944340",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Louise Wagner-Escobar, AUD
• Alexis Wagner
• Angela B Wagner, D.O.
• Ashley Nicole Wagner, BCBA
• Beth Schuckman Wagner, RPH
• Carol Wagner, LCSW
• Cathy Wagner, M.D.
• David Lee Wagner, M.D.
• Dennis L Wagner, MD
• Donna K Wagner, NP

• Nurse Practitioner in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.