Nicholas R Wagner, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN9243050 Issued in FL

Practice address

1002 N. Arnold Rd.
Suite 101
Panama City Beach, FL 32413

Phone

(850) 238-4100

NPI assigned

May 6, 2010

Sex

Male

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 FL

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

University of Alabama School of Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tallahassee Memorial Healthcare IncGroup PAC ID 6103724778, 498 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nicholaswagner@tmhpp.allscriptsdirect.net

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.

• Tallahassee Memorial Healthcare Inc

  • General Acute Care Hospital
  • Tallahassee, FL
  • NPI 1437177664
  Medicare reassignment Care Compare group NPD
• Tallahassee Memorial Healthcare Inc

  • Family Medicine Physician
  • Tallahassee, FL
  • NPI 1366293102
  NPD
• Tallahassee Memorial Healthcare Inc

  • Internal Medicine Physician
  • Tallahassee, FL
  • NPI 1487932422
  NPD
• Tallahassee Memorial Healthcare Inc

  • Anesthesiology Physician
  • Panama City Beach, FL
  • NPI 1992532477
  NPD

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

{
    "created_epoch": "1273104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1770801359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 N. ARNOLD RD.",
            "address_2": "SUITE 101",
            "city": "PANAMA CITY BEACH",
            "state": "FL",
            "postal_code": "32413",
            "telephone_number": "850-238-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 N. ARNOLD RD.",
            "address_2": "SUITE 101",
            "city": "PANAMA CITY BEACH",
            "state": "FL",
            "postal_code": "32413",
            "telephone_number": "850-238-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "NICHOLAS",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-06",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN9243050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Villiers, CCC-SLP
• Kyle Steven Vinsh, PT, DPT
• Vitality Integrative Health, P.a., LLC
• Vivos Panama City Beach Inc
• Vop Landing PCB, LLC
• Wal-Mart Stores East LP
• Wal-Mart Stores East LP
• Wal-Mart Stores East, LP
• Lori Waldron
• Walgreen Co

• Family Nurse Practitioner in Panama City Beach, FL
• Providers in Panama City Beach, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; 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.