NPIMap

Individual provider Active NPI

Jill Irene Wagoner, NP

  • Adult Health Nurse Practitioner
  • La Crosse, WI
National Provider Identifier
1942928114
Registry record updated Sep 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
11818-33 Issued in WI
Practice address
1900 South Ave
La Crosse, WI 54601-5467
Phone
(608) 397-3123
NPI assigned
Aug 15, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 11818-33 WI
Adult Health Nurse Practitioner 363LA2200X 11818-33 WI Primary

Addresses

Primary practice location

1900 South Ave
La Crosse, WI 54601-5467

Mailing address

1836 South Ave
La Crosse, WI 54601-5429
Phone (608) 782-7300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220919001954 WI Practitioner - Nurse Practitioner 8527443142 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1836 S Ave
La Crosse, WI 54601-5429
Phone (608) 783-7300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11818-33WIMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gundersen Lutheran Medical Center, Inc CurrentSince Sep 16, 2022 Accepting new patients
Gundersen Lutheran Medical Center Inc Current Accepting new patients
Gundersen Lutheran Medical Center, Inc CurrentSince Sep 16, 2022 Accepting new patients
Gundersen Lutheran Medical Center Inc Past Accepting new patients

Locations

1900 South Ave
La Crosse, WI 54601
Phone (608) 775-2287

1910 South Ave
La Crosse, WI 54601
Phone (608) 775-2287

1836 South Ave
La Crosse, WI 54601
Phone (608) 788-8102

Interoperability endpoints

  • Direct secure messaging: jwagoner82159@direct.emplifyhealth.org

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 7

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": "1660521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789430400000",
    "number": "1942928114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1836 SOUTH AVE",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546015429",
            "telephone_number": "608-782-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 SOUTH AVE",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546015467",
            "telephone_number": "608-397-3123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGONER",
        "first_name": "JILL",
        "middle_name": "IRENE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-15",
        "last_updated": "2026-09-15",
        "certification_date": "2026-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "WI",
            "license": "11818-33",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "WI",
            "license": "11818-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Crosse, WI

Sources for this page

Verify at the official NPI Registry.