Shonna Marie Wagaman, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R212454 Issued in MD

Practice address

23000 Moakley St Ste 206
Leonardtown, MD 20650-2917

Phone

(410) 571-2946

Fax

(301) 632-6187

NPI assigned

Jul 28, 2020

Last updated

Sep 9, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC, MD2 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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Pain Management Specialists LLCGroup PAC ID 3173513959, 76 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shonna.wagaman.1@11679.direct.athenahealth.com

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.

• Advanced Pain Management Specialists, LLC

  dba Clearway Pain Solutions

  • Interventional Pain Medicine Physician
  • Annapolis, MD
  • NPI 1861418220

  DC

  Medicare reassignment Care Compare group NPD
• Advanced Pain Management Specialists, LLC

  dba Clearway Pain Solutions

  • Durable Medical Equipment & Medical Supplies
  • Silver Spring, MD
  • NPI 1376355438
  NPD
• Advanced Pain Management Specialists, LLC

  dba Clearway Pain Solutions

  • Clinical Medical Laboratory
  • Owings Mills, MD
  • NPI 1316315740
  NPD (past)

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

{
    "created_epoch": "1595894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599609600000",
    "number": "1760091581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 PARK CENTER CT STE 200",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211174221",
            "telephone_number": "410-571-2946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23000 MOAKLEY ST STE 206",
            "city": "LEONARDTOWN",
            "state": "MD",
            "postal_code": "206502917",
            "telephone_number": "410-571-2946",
            "fax_number": "301-632-6187"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "39510 Flora Way",
            "address_purpose": "LOCATION",
            "city": "Mechanicsville",
            "state": "MD",
            "postal_code": "206593337",
            "country_code": "US",
            "telephone_number": "301-672-7221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAGAMAN",
        "first_name": "SHONNA",
        "middle_name": "MARIE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-28",
        "last_updated": "2020-09-09",
        "certification_date": "2020-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R212454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Allison Vandenbos
• Esther Vanderwal, LCSW-C
• Verghese & Ling M.D.P.a. (Mid Atlantic Skin Surgery Institute)
• George K Verghese
• Jennifer E Voorhaar, LCSW-C
• Walden Sierra, Inc.
• Victoria E Waldron, DPT
• Walgreen Co (Walgreens #19471)
• Walgreen Co. (Walgreens #19471)
• Nazmun Nahar Walia

• Family Nurse Practitioner in Leonardtown, MD
• Providers in Leonardtown, MD by specialty
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2020; 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.