Maddison Wagner, CPNP- PC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

APRN.CNP.025209 Issued in OH

Practice address

700 Childrens Dr
Columbus, OH 43205-2639

Phone

(614) 722-3279

NPI assigned

Sep 1, 2020

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH, NE2 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

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Pediatric Academic Association, Inc.

  • Pediatrics Physician
  • Columbus, OH
  • NPI 1063419943
  Medicare reassignment NPD
• Father Flanagan'S Boys' Home

  • Pediatrics Physician
  • Omaha, NE
  • NPI 1295821825
  Medicare reassignment NPD
• Nationwide Children'S Hospital

  • Dental Clinic/Center
  • Columbus, OH
  • NPI 1407013964
  NPD (past)
• ENT Services PC

  • Otolaryngology Physician
  • Omaha, NE
  • NPI 1194822130
  NPD (past)
• Father Flanagan'S Boys Home

  • Psychologist
  • Boys Town, NE
  • NPI 1265405419
  NPD (past)

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

{
    "created_epoch": "1598918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644796800000",
    "number": "1801400502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 CHILDRENS DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432052664",
            "telephone_number": "614-722-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 CHILDRENS DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432052639",
            "telephone_number": "614-722-3279"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1777 E Dublin Granville Rd # 177",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432293502",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2599 S Hamilton Rd",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432324964",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "655 E Livingston Ave",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432052618",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "MADDISON",
        "credential": "CPNP- PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-01",
        "last_updated": "2022-02-14",
        "certification_date": "2022-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OH",
            "license": "APRN.CNP.025209",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0421126",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julie Wagner, M.A., CCC/SLP
• Karly Kathleen Wagner, LPN
• Katelyn Wagner, LISW
• Kathryn Clare Wagner, PA-C
• Laura Jean Wagner, LSW
• Matthew Gary Wagner
• Matthew M Wagner, MD
• Rebecca Anne Wagner, APRN-CNM
• Samantha Wagner, PHARMD
• Shana Wagner, CPNP-PC

• Pediatric Nurse Practitioner in Columbus, OH
• Providers in Columbus, OH by specialty
• Pediatric Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.