Active NPI
John Allen Wagner, DO
- Rheumatology Physician
- Fort Gordon, GA
National Provider Identifier
1902592991
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rheumatology Physician
- License
- 2024037976
- Practice address
- 300 East Hospital Rd
Fort Gordon, GA 30905-5650 - Phone
- (706) 787-6945
- NPI assigned
- Apr 13, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rheumatology Physician | 207RR0500X | 2024037976 | MO | Primary |
Addresses
Primary practice location
300 East Hospital Rd
Fort Gordon, GA 30905-5650
Mailing address
300 East Hospital Road
Fort Gordon, GA 30905-5650
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Osteopathy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1681344000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788220800000",
"number": "1902592991",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 EAST HOSPITAL ROAD",
"city": "FORT GORDON",
"state": "GA",
"postal_code": "309055650"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 EAST HOSPITAL RD",
"city": "FORT GORDON",
"state": "GA",
"postal_code": "309055650",
"telephone_number": "706-787-6945"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGNER",
"first_name": "JOHN",
"middle_name": "ALLEN",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-04-13",
"last_updated": "2026-09-01",
"certification_date": "2026-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "207RR0500X",
"taxonomy_group": "",
"desc": "Internal Medicine, Rheumatology",
"state": "MO",
"license": "2024037976",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Gordon, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.