Susan M Wagner, ARNP, CRNP, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

11007696 Issued in FL

Practice address

4400 E Highway 20 Ste 207
Niceville, FL 32578-7700

Phone

(850) 806-2440

NPI assigned

Jun 26, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in AL, FL2 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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Enterprise Urgent CareGroup PAC ID 1456647197, 35 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• HCA Florida Twin Cities Hospital Hospital, Niceville, FL, CCN 100054

Medicare enrollment (NPD)

Enrolled

Credentials

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.

• Rose Family Healthcare, LLC

  • Primary Care Clinic/Center
  • Niceville, FL
  • NPI 1033925342
  Medicare reassignment NPD Authorized official
• Enterprise Urgent Care

  • Urgent Care Clinic/Center
  • Enterprise, AL
  • NPI 1285180729
  Medicare reassignment Care Compare group NPD
• Ivycreek of Elmore LLC

  • Rural Health Clinic/Center
  • Wetumpka, AL
  • NPI 1396066650
  NPD (past)

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

• Okaloosa Hospital Inc

  • General Acute Care Hospital
  • Niceville, FL
  • NPI 1891732988
  Care Compare affiliation

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

{
    "created_epoch": "1593129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754179200000",
    "number": "1811514722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 E HIGHWAY 20 STE 207",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325787700",
            "telephone_number": "850-806-2440",
            "fax_number": "334-212-0232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 E HIGHWAY 20 STE 207",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325787700",
            "telephone_number": "850-806-2440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6582 Boll Weevil Cir",
            "address_purpose": "LOCATION",
            "city": "Enterprise",
            "state": "AL",
            "postal_code": "363309424",
            "country_code": "US",
            "telephone_number": "334-347-2027",
            "fax_number": "334-347-2299",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "SUSAN",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "ARNP, CRNP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-26",
        "last_updated": "2025-08-03",
        "certification_date": "2025-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-097016",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "11007696",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11007696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victor Vega-Mercado
• Kimberly Vele
• Olivia Victor, RBT
• Jodi L. Visi
• Hailey Lynn Wagner, PT, DPT
• Wal-Mart Stores East LP
• Wal-Mart Stores East LP
• Walgreen Co
• Sherry Dawn Walker, L.P.N
• Anna Walsh

• Family Nurse Practitioner in Niceville, FL
• Providers in Niceville, 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 3, 2025; 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.