Stephanie A Wagner, PNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

71006717A Issued in IN

Practice address

411 E Chestnut St # Street6
Louisville, KY 40202-1713

Phone

(502) 588-3650

Fax

(502) 588-7852

NPI assigned

Nov 28, 2016

Last updated

Nov 18, 2024By 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 2

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Norton Children's Medical Group, LLC

  dba Norton Children's Behavioral and Mental Health

  • Psychiatry Physician
  • Louisville, KY
  • NPI 1457999096

  Nurse Practitioner

  NPD
• Commission for Children With Special Health Car

  • Public Health or Welfare Agency
  • Louisville, KY
  • NPI 1831197953
  NPD (past)

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

{
    "created_epoch": "1480291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1811430655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776879",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776879",
            "telephone_number": "502-588-9490",
            "fax_number": "502-272-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 E CHESTNUT ST # STREET6",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021713",
            "telephone_number": "502-588-3650",
            "fax_number": "502-588-7852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "STEPHANIE",
        "middle_name": "A",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-28",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71006717A",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IN",
            "license": "71006717A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicsoap.nortonhealthcare.org/FHIRPRD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "411 E Chestnut St # Street6",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402021713",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "swagner184745@direct.nortonhealthcare.org",
            "affiliation": "N",
            "address_1": "411 E Chestnut St # Street6",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402021713",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Paige Nicole Wagner, PHARM D
• Patrick Joseph Wagner, LCSW
• Paula Anne-Marie Wagner, PT
• Shaina Wagner
• Skylar Wagner, LMT
• Wagners Pharmacy
• Wagners Pharmacy Inc
• Clare Thompson Wahl, PHD
• Lori Lynae Wahl, PT, DPT
• Timothy James Wahl, D.M.D.

• Pediatric Nurse Practitioner in Louisville, KY
• Providers in Louisville, KY by specialty
• Pediatric Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.