NPIMap

Individual provider Active NPI

Myesha J. Wagner, FNP-C

  • Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1952032112
Registry record updated Oct 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN258179 Issued in GA
Practice address
36 Linden Ave NW
Atlanta, GA 30308
Phone
(404) 778-0278
Fax
(404) 686-8266
NPI assigned
Jun 20, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN258179 GA Primary
Family Nurse Practitioner 363LF0000X RN258179 GA

Addresses

Primary practice location

36 Linden Ave NW
Atlanta, GA 30308

Mailing address

36 Linden Ave NE
Atlanta, GA 30308-2951
Phone (404) 778-8266

Other identifiers 2

IdentifierTypeStateIssuer
G34406AOtherGAMEDICARE PTAN
003274648AMedicaidGA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address myesha.wagneraprnfnpc.p1@direct.gacancer.nextgenshare.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20220928003470 GA Practitioner - Nurse Practitioner 8729464755 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Emory Clinic IncGroup PAC ID 8820901408, 3,507 clinicians

Practice addresses (Care Compare)

1365 Clifton Rd NE
Atlanta, GA 30322-1013
Phone (404) 778-7525

2201 Henderson Mill Rd NE
Atlanta, GA 30345-2711

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN258179GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
NSH Cancer Institute Professional Services G LLC CurrentSince Sep 26, 2022 Accepting new patients
NSH Cancer Institute Professional Services G, LLC CurrentSince Sep 26, 2022 Accepting new patients
The Emory Clinic Inc CurrentSince Sep 11, 2023 Accepting new patients
Northside Imaging LLC Past Accepting new patients
NSH Cancer Institute Professional Services G, LLC Past Accepting new patients

Locations

2201 Henderson Mill Rd NE
Ste 160
Atlanta, GA 30345
Phone (404) 251-2193

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

1835 Savoy Dr
Ste 300
Atlanta, GA 30341
Phone (678) 288-9555

132 Old Norton Rd
Ste 200
Fayetteville, GA 30215
Phone (678) 817-1117

1045 Southcrest Dr
Ste 200
Stockbridge, GA 30281
Phone (678) 289-0549

Interoperability endpoints

  • Direct secure messaging: myesha.wagneraprnfnpc.p1@direct.gacancer.nextgenshare.com
  • Direct secure messaging: mwagner681792@direct.emory.org

Organizations & group practices 5

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 5

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": "1655683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760486400000",
    "number": "1952032112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 LINDEN AVE NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303082951",
            "telephone_number": "404-778-8266",
            "fax_number": "404-686-8266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 LINDEN AVE NW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30308",
            "telephone_number": "404-778-0278",
            "fax_number": "404-686-8266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "MYESHA",
        "middle_name": "J.",
        "name_prefix": "Miss",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-20",
        "last_updated": "2025-10-15",
        "certification_date": "2025-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN258179",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN258179",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "G34406A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003274648A",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "myesha.wagneraprnfnpc.p1@direct.gacancer.nextgenshare.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Edge",
            "address_1": "132 Old Norton Rd Ste 200",
            "city": "Fayetteville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "302154873",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.