Rebekah Marie Wagoner, APRN, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP142101 Issued in TX

Practice address

1023 N Mound St Ste E
Nacogdoches, TX 75961-4453

Phone

(936) 305-4130

Fax

(936) 305-4127

NPI assigned

Aug 19, 2019

Last updated

Dec 19, 2022By 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 TX

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wagoner Health Clinic PLLCGroup PAC ID 9638544018, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Nacogdoches Medical Center Hospital, Nacogdoches, TX, CCN 450656
• Nacogdoches Memorial Hospital Hospital, Nacogdoches, TX, CCN 450508
• Woodland Heights Medical Center Hospital, Lufkin, TX, CCN 450484

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rebekah.wagoner.1@27888.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.

• Wagoner Health Clinic, PLLC

  dba Wagoner Family Health Clinic

  • Primary Care Nurse Practitioner
  • Nacogdoches, TX
  • NPI 1396454484
  Medicare reassignment Care Compare group NPD Authorized official

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

• Nacogdoches County Hospital District

  dba NCHD Memorial Hospital

  • Rural Acute Care Hospital
  • Nacogdoches, TX
  • NPI 1801831748
  Care Compare affiliation
• Piney Woods Healthcare System, L.P.

  dba Woodland Heights Medical Center

  • General Acute Care Hospital
  • Lufkin, TX
  • NPI 1487607792
  Care Compare affiliation
• TH Healthcare, LTD

  dba Nacogdoches Medical Center

  • General Acute Care Hospital
  • Nacogdoches, TX
  • NPI 1700885076
  Care Compare affiliation

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

{
    "created_epoch": "1566172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671408000000",
    "number": "1770130437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1023 N MOUND ST STE E",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759614453",
            "telephone_number": "936-305-4130",
            "fax_number": "936-305-4127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1023 N MOUND ST STE E",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759614453",
            "telephone_number": "936-305-4130",
            "fax_number": "936-305-4127"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "617 Russell Blvd",
            "address_purpose": "LOCATION",
            "city": "Nacogdoches",
            "state": "TX",
            "postal_code": "759651247",
            "country_code": "US",
            "telephone_number": "936-305-5109",
            "fax_number": "936-305-5112",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAGONER",
        "first_name": "REBEKAH",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-19",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP142101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shyam A Vyas, MD
• Kalisha Wade, CCC SLP
• Ladedra Wade
• Wagoner Health Clinic, PLLC (Wagoner Family Health Clinic)
• James Lucas Wagoner, MSN, APRN, FNP-C
• Cara Danielle Wagstaff, COTA
• Wal-Mart Stores Texas LLC (Walmart Pharmacy 10-4674)
• Wal-Mart Stores Texas LLC (Walmart Pharmacy 10-0163)
• Wal-Mart Stores Texas, LP (Vision Center 30-0163)
• Walgreen Co (Walgreens #09400)

• Family Nurse Practitioner in Nacogdoches, TX
• Providers in Nacogdoches, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 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.
• 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.