Active NPI
Marti Wagers, NP
- Family Nurse Practitioner
- Portland, IN
National Provider Identifier
1639892136
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 71013022A
- Practice address
- 980 N Meridian Street
Portland, IN 47371-1129 - Phone
- (260) 703-3312
- NPI assigned
- Sep 21, 2022
- 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 | 71013022A | IN | Primary |
Addresses
Primary practice location
980 N Meridian Street
Portland, IN 47371-1129
Mailing address
PO Box 306417
Nashville, TN 37230-6417
Phone (931) 253-1110
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- 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 |
|---|---|---|---|---|
| I20250807000904 | IN | Order and Referring Only - Nurse Practitioner | 2163808163 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71013022A | IN | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1663718400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663718400000",
"number": "1639892136",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 306417",
"city": "NASHVILLE",
"state": "TN",
"postal_code": "372306417",
"telephone_number": "931-253-1110",
"fax_number": "931-722-9919"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "980 N MERIDIAN STREET",
"city": "PORTLAND",
"state": "IN",
"postal_code": "473711129",
"telephone_number": "260-703-3312"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGERS",
"first_name": "MARTI",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-09-21",
"last_updated": "2022-09-21",
"certification_date": "2022-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IN",
"license": "71013022A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2022; 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.