Clayton Thomas Wagner

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

68745 Issued in MN

Practice address

15350 English Ave
Apple Valley, MN 55124-6252

Phone

(952) 431-8500

NPI assigned

Apr 10, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN, WI2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Family Practice

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fairview Clinics 799 clinicians

Post Acute Medical PLLC 433 clinicians

Northfield Hospital 121 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northfield Hospital Hospital, Northfield, MN, CCN 240014
• Edenbrook of Edina Nursing home, Minneapolis, MN, CCN 245275

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Fairview Clinics

  • Primary Care Clinic/Center
  • Minneapolis, MN
  • NPI 1346432218

  MN

  Medicare reassignment Care Compare group NPD
• Northfield Hospital

  • Rural Acute Care Hospital
  • Northfield, MN
  • NPI 1417990805

  MN

  Medicare reassignment Care Compare group NPD
• Fairview Clinics

  • Specialist
  • River Falls, WI
  • NPI 1811550155

  WI

  Medicare reassignment Care Compare group NPD
• Post Acute Medical PLLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Lanham, MD
  • NPI 1730713025

  MN

  Medicare reassignment Care Compare group NPD
• Altea Medical Minnesota PLLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Saint Cloud, MN
  • NPI 1245022565

  MN

  Medicare reassignment NPD
• Group Health, Inc.

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1710924683

  MN, WI

  Medicare reassignment NPD
• Healtheast Medical Research Institute

  • Clinic/Center
  • Vadnais Heights, MN
  • NPI 1639125503

  MN

  Medicare reassignment NPD
• Northfield Hospital

  • Multi-Specialty Clinic/Center
  • Faribault, MN
  • NPI 1588112098
  Care Compare group NPD
• Northfield Hospital

  • Orthopaedic Surgery Physician
  • Northfield, MN
  • NPI 1205862844
  Care Compare group
• Northfield Hospital

  • Multi-Specialty Clinic/Center
  • Northfield, MN
  • NPI 1255367629
  Care Compare group
• Northfield Hospital

  • Urgent Care Clinic/Center
  • Northfield, MN
  • NPI 1437668159
  Care Compare group
• Northfield Hospital

  • Primary Care Clinic/Center
  • Kenyon, MN
  • NPI 1518631407
  Care Compare group

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

• Edina Nursing and Rehab, LLC

  • Skilled Nursing Facility
  • Edina, MN
  • NPI 1508391749

  Nursing home

  Care Compare affiliation
• Northfield Hospital

  • Rural Acute Care Hospital
  • Northfield, MN
  • NPI 1417990805

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1523318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728000000000",
    "number": "1902303589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S",
            "address_2": "MS 21110Q",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15350 ENGLISH AVE",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551246252",
            "telephone_number": "952-431-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "CLAYTON",
        "middle_name": "THOMAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-10",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "68745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natan Vogman, RN
• David Vollmers, LADC
• Chanda Dalida Vongprasert
• Kaitlan Vossen, MD
• Leah Wachter, LADC
• Shelley Nelson Wakefield, D.D.S.
• Wal-Mart Stores, Inc.
• Vonna P Wala
• Walgreen Co
• Walgreen Co

• All providers in Apple Valley, MN
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 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.
• 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.