Individual provider Active NPI

Jennifer Ella Wagy, DNP, FNP-BC, NP-C

  • Primary Care Nurse Practitioner
  • Casper, WY
National Provider Identifier
1861042392
Registry record updated Oct 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
44650 Issued in WY
Practice address
6500 E 2ND St
Casper, WY 82609-4338
Phone
(307) 577-5100
Fax
(307) 233-0613
NPI assigned
Sep 17, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 44650 WY Primary

Addresses

Primary practice location

6500 E 2ND St
Casper, WY 82609-4338

Mailing address

6500 E 2ND St
Casper, WY 82609-4338
Phone (307) 577-5100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
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

Enrollment IDStateProvider typePAC IDDetails
I20191216001545 WY Practitioner - Nurse Practitioner 2567896061 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Memorial Medical Group LLCGroup PAC ID 1254876683, 40 clinicians

Practice addresses (Care Compare)

6500 E 2ND St
Casper, WY 82609-4338
Phone (307) 577-5100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
33.71 of 100Reported as group
Quality
39.66
Improvement activities
0

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital of Converse County CurrentSince Sep 1, 2023 Accepting new patients
Summit Memorial Medical Group LLC CurrentSince Jul 1, 2024 Accepting new patients
Memorial Hospital of Carbon County Current Accepting new patients
Memorial Hospital of Converse County CurrentSince Sep 1, 2023 Accepting new patients

Locations

6500 E 2nd St
Casper, WY 82609
Phone (307) 235-4180

111 S 5th St
Douglas, WY 82633
Phone (307) 358-6200

222 S 5th St
Douglas, WY 82633
Phone (307) 286-6738

700 E Center St
Douglas, WY 82633
Phone (307) 352-8946

300 3rd St
Rawlins, WY 82301
Phone (307) 324-3403

2221 Elm St
Rawlins, WY 82301
Phone (307) 324-2221

Organizations & group practices 4

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 2

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": "1568678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697673600000",
    "number": "1861042392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6500 E 2ND ST",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826094338",
            "telephone_number": "307-577-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 E 2ND ST",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826094338",
            "telephone_number": "307-577-5100",
            "fax_number": "307-233-0613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGY",
        "first_name": "JENNIFER",
        "middle_name": "ELLA",
        "credential": "DNP, FNP-BC, NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-17",
        "last_updated": "2023-10-19",
        "certification_date": "2023-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "WY",
            "license": "44650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Casper, WY

Sources for this page

Verify at the official NPI Registry.