Jaclyn Anne Wagner, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

APRN11020833 Issued in FL

Practice address

1600 SW Archer Rd
Gainesville, FL 32610-5776

Phone

(352) 392-4541

NPI assigned

Jun 6, 2011

Sex

Female

Sole proprietor

No

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 GA, FL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Villages Regional Hospital Physician Services LLCGroup PAC ID 0244688893, 198 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jwagner740053@direct.shands.ufl.edu

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.

• Villages Regional Hospital Physician Services LLC

  • Surgery Physician
  • Leesburg, FL
  • NPI 1700669926
  Medicare reassignment Care Compare group NPD
• Flagler Professional Health Care Services, Inc.

  dba UF Health Urgent Care-Flagler Hospital

  • Urgent Care Clinic/Center
  • St Augustine, FL
  • NPI 1811739873
  Medicare reassignment NPD
• Florida Clinical Practice Association Inc

  dba UF Health Physicians

  • Surgery Physician
  • Gainesville, FL
  • NPI 1063463768

  Family Medicine

  Medicare reassignment NPD
• Palm Harbor Family Practice and Walk in Clinic PA

  • General Practice Physician
  • Palm Coast, FL
  • NPI 1831311810
  Medicare reassignment NPD
• Peachtree City Urgent Care, Inc

  • Emergency Medicine Physician
  • Peachtree City, GA
  • NPI 1336388636
  Medicare reassignment NPD
• Radiology & Medical Imagery of Newnan, PC

  dba Piedmont South Imaging

  • Diagnostic Radiology Physician
  • Newnan, GA
  • NPI 1447268842
  Medicare reassignment NPD
• Flagler Professional Health Care Services, Inc.

  dba UF Health Urgent Care - MuraBella

  • Urgent Care Clinic/Center
  • St Augustine, FL
  • NPI 1598507014
  NPD
• Florida Clinical Practice Association Inc

  dba UF Health Family Medicine Ocala Heath Brook

  • Durable Medical Equipment & Medical Supplies
  • Ocala, FL
  • NPI 1609529478
  NPD
• Fayette Community Hospital, Inc.

  dba Piedmont Fayette Hospital

  • General Acute Care Hospital
  • Fayetteville, GA
  • NPI 1528027240
  NPD (past)

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

{
    "created_epoch": "1307318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756857600000",
    "number": "1720372964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 740861",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303740861",
            "telephone_number": "904-819-4539",
            "fax_number": "904-819-4906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326105776",
            "telephone_number": "352-392-4541"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 Health Park Blvd",
            "address_purpose": "LOCATION",
            "city": "Saint Augustine",
            "state": "FL",
            "postal_code": "320865776",
            "country_code": "US",
            "telephone_number": "904-823-3401",
            "fax_number": "904-829-8649",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1255 Highway 54 W",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "GA",
            "postal_code": "302144526",
            "country_code": "US",
            "telephone_number": "770-719-7911",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "JACLYN",
        "middle_name": "ANNE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-06",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11020833",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11020833",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "APRN11020833",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "126442300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Waf Essentials LLC
• Annette Marie Wagle, LPN
• Kerry Lyn Wagner-Bellocchio, PSY.D.
• Diane Marie Wagner, LISW
• Emma Christine Wagner, ATC, LAT
• Jordan Wagner
• Karyn E. Wagner, ARNP
• Mary H Wagner, MD
• Mona H Wagner, CRNA
• Richard Wagner

• Nurse Practitioner in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2025; 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.