Active NPI
Anna Wagner, MD
- Nurse Practitioner
- Taylorsville, UT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 10756382-4405
- Practice address
- 3845 W 4700 S
Taylorsville, UT 84129-3454 - Phone
- (801) 840-2170
- NPI assigned
- Jul 29, 2020
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 10756382-4405 | UT | Primary |
Addresses
Primary practice location
3845 W 4700 S
Taylorsville, UT 84129-3454
Mailing address
PO Box 27128
Salt Lake City, UT 84127-0128
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10756382-3102 | Other | UT | UTAH DOPL |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Bluemark LLC/ Office Ally |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
181 E Medical Tower Dr
Murray, UT 84107-4872
Phone (801) 314-7750
2000 S 900
Salt Lake City, UT 84105-3208
Phone (801) 464-7788
389 S 900
Salt Lake City, UT 84102-2310
Phone (385) 282-2400
390 N Main St
Bountiful, UT 84010-6046
Phone (801) 776-4444
5373 W Lake Park Blvd
West Valley City, UT 84120-8208
Phone (801) 902-8080
6272 S Highland Dr
Murray, UT 84121-2126
Phone (801) 871-6300
700 S Hwy 99
Suite 3
Fillmore, UT 84631-5137
Phone (801) 357-4600
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10756382-4405 | UT | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ihc Health Services Inc | Current | Accepting new patients | |
| Ihc Health Services Inc | Current | Accepting new patients | |
| Ihc Health Services, Inc. | Current | Accepting new patients |
Locations
700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555
3845 W 4700 S
West Valley City, UT 84129
Phone (801) 840-2020
1300 SE Cardinal Ct
Ste 190
Vancouver, WA 98683
Phone (360) 448-4479
Organizations & group practices 3
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.
-
- Multi-Specialty Clinic/Center
- Sandy, UT
- NPI 1942325154
-
- Emergency Medicine Physician
- West Valley City, UT
- NPI 1568818003
-
- Psychiatry Physician
- St George, UT
- NPI 1023843844
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1595980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1769644800000",
"number": "1689283269",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 27128",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841270128"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3845 W 4700 S",
"city": "TAYLORSVILLE",
"state": "UT",
"postal_code": "841293454",
"telephone_number": "801-840-2170"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGNER",
"first_name": "ANNA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-07-29",
"last_updated": "2026-01-29",
"certification_date": "2026-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "UT",
"license": "10756382-4405",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UTAH DOPL",
"identifier": "10756382-3102",
"state": "UT"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
"affiliation": "Y",
"endpointDescription": "2.16.840.1.113883.3.2019.3",
"affiliationName": "Bluemark LLC/ Office Ally",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CMS esMD eMDR",
"address_1": "1300 SE Cardinal Ct Ste 190",
"city": "Vancouver",
"state": "WA",
"country_code": "US",
"postal_code": "986839683",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Taylorsville, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 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.