Amy R Waggner, RN MSN FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

71001500 Issued in IN

Practice address

1402 Grand Ave
Washington, IN 47501-2122

Phone

(812) 257-0383

Fax

(812) 257-0433

NPI assigned

Mar 9, 2006

Last updated

Jan 2, 2021By 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 1

Addresses

Other identifiers 4

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Nurse Practitioner

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Daviess County HospitalGroup PAC ID 1557271665, 67 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amywaggner@dchpm.allscriptsdirect.net

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.

• Daviess County Hospital

  dba Daviess County Hospital Physicians

  • General Acute Care Hospital
  • Washington, IN
  • NPI 1619154820
  Medicare reassignment Care Compare group NPD
• Daviess County Hospital

  dba Daviess Community Hospital Orthopaedics

  • Orthopaedic Surgery Physician
  • Washington, IN
  • NPI 1083915326
  NPD
• Daviess County Hospital

  dba Daviess Community Hospital Montgomery Medical Clinic

  • Rural Health Clinic/Center
  • Montgomery, IN
  • NPI 1336959279
  NPD

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609545600000",
    "number": "1861460537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 760",
            "city": "WASHINGTON",
            "state": "IN",
            "postal_code": "475010760",
            "telephone_number": "812-254-7310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1402 GRAND AVE",
            "city": "WASHINGTON",
            "state": "IN",
            "postal_code": "475012122",
            "telephone_number": "812-257-0383",
            "fax_number": "812-257-0433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGGNER",
        "first_name": "AMY",
        "middle_name": "R",
        "credential": "RN MSN FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-09",
        "last_updated": "2021-01-02",
        "certification_date": "2021-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71001500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200461840",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00152106",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000390541",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD GROUP",
            "identifier": "CA5604",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amywaggner@dchpm.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "1402 Grand Ave",
            "city": "Washington",
            "state": "IN",
            "country_code": "US",
            "postal_code": "475012122",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Nurse Practitioner in Washington, IN
• Providers in Washington, IN by specialty
• Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2021; 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.