Individual provider Active NPI

Sarah Wagoner

  • Family Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1720447683
Registry record updated Apr 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71006425A/B Issued in IN
Practice address
1801 N Senate Blvd Ste 4000
Indianapolis, IN 46202-1184
Phone
(317) 962-2500
NPI assigned
Feb 19, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 28157404A IN
Nurse Practitioner 363L00000X 71006425 IN
Family Nurse Practitioner 363LF0000X 71006425A/B IN Primary

Addresses

Primary practice location

1801 N Senate Blvd Ste 4000
Indianapolis, IN 46202-1184

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170213000243 IN Practitioner - Nurse Practitioner 0446533749 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Practice addresses (Care Compare)

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
28157404AINMDRegistered Nurse
71006425INMDNurse Practitioner
71006425A/BINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Iu Health Medical Group, LLC Nurse Practitioner CurrentSince Jul 1, 2025 Accepting new patients
Indiana University Health Care Associates, Inc Family CurrentSince Jan 10, 2017 Accepting new patients
Indiana University Health, Inc Nurse Practitioner CurrentSince Jan 10, 2017 Accepting new patients
University Medical Diagnostic Associates, Inc. Past Accepting new patients
Indiana University Health North Hospital, Inc Past Accepting new patients

Locations

5208 Reliable Pkwy
Chicago, IL 60686

2242 Reliable Pkwy
Chicago, IL 60686

1801 Senate Blvd
Ste 4000
Indianapolis, IN 46202
Phone (317) 962-0500

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

1801 Senate Blvd
Ste 3100
Indianapolis, IN 46202
Phone (317) 962-4400

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

1701 N Senate Blvd
Bldg C6
Indianapolis, IN 46202
Phone (913) 962-2000

1801 Senate Blvd
Ste 310
Indianapolis, IN 46202
Phone (317) 957-2070

2209 John R Wooden Dr
Martinsville, IN 46151
Phone (765) 342-3364

Interoperability endpoints

  • Direct secure messaging: swagone2@direct.iuhealth.org

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1455840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650153600000",
    "number": "1720447683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 N SENATE BLVD STE 4000",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462021184",
            "telephone_number": "317-962-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGONER",
        "first_name": "SARAH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-19",
        "last_updated": "2022-04-17",
        "certification_date": "2022-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28157404A",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71006425",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71006425A/B",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.