Individual provider Active NPI

Christy Wagner, MD

  • Family Medicine Physician
  • Gainesville, GA
National Provider Identifier
1790778033
Registry record updated Oct 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
050067 Issued in GA
Practice address
1856-14 Thompson Bridge Rd
Gainesville, GA 30501-1663
Phone
(770) 534-2800
Fax
(770) 534-2889
NPI assigned
Aug 23, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 050067 GA Primary

Addresses

Primary practice location

1856-14 Thompson Bridge Rd
Gainesville, GA 30501-1663

Mailing address

PO Box 742616
Atlanta, GA 30374-2616
Phone (770) 219-8420

Other identifiers 1

IdentifierTypeStateIssuer
000907409BMedicaidGA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cwagner29346@nghs.gadirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150623001818 GA Practitioner - Family Practice 8921160789 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of South Carolina School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northeast Georgia Physicians Group IncGroup PAC ID 6901898386, 884 clinicians

Practice addresses (Care Compare)

3641 Thompson Bridge Rd
Gainesville, GA 30506-1515
Phone (770) 219-9460

597 S Enota Dr NE
Gainesville, GA 30501-2545
Phone (770) 219-7777

Hospital & facility affiliations

  • Northeast Georgia Medical Center, Inc Hospital, Gainesville, GA, CCN 110029

Merit-based Incentive Payment System (MIPS)

Final score
87.83 of 100Reported as group
Quality
80.36
Promoting interoperability
100
Improvement activities
40
Cost
79.08

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
050067GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Georgia Physicians Group Inc Family Medicine CurrentSince Apr 1, 2002 Accepting new patients

Locations

1515 River Pl
Ste 100
Braselton, GA 30517
Phone (770) 848-6195

597 S Enota Dr NE
Gainesville, GA 30501
Phone (770) 219-8275

950 S Enota Dr NE
Ste A
Gainesville, GA 30501
Phone (678) 450-8969

Interoperability endpoints

  • Direct secure messaging: cwagner29346@nghs.gadirect.net

Organizations & group practices 1

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.

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": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602547200000",
    "number": "1790778033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742616",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303742616",
            "telephone_number": "770-219-8420",
            "fax_number": "770-219-8440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1856-14 THOMPSON BRIDGE RD",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305011663",
            "telephone_number": "770-534-2800",
            "fax_number": "770-534-2889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "CHRISTY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-23",
        "last_updated": "2020-10-13",
        "certification_date": "2020-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "050067",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000907409B",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cwagner29346@nghs.gadirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1856-14 Thompson Bridge Rd",
            "city": "Gainesville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "305011663",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

Verify at the official NPI Registry.