NPIMap

Individual provider Active NPI

John Francis Wagener, M.D.

  • Interventional Cardiology Physician
  • Sioux Falls, SD
National Provider Identifier
1972879161
Registry record updated Jul 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
11931 Issued in SD
Practice address
4520 W 69TH St
Sioux Falls, SD 57108-8148
Phone
(605) 977-5000
Fax
(605) 977-5377
NPI assigned
Apr 1, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 35.133649 OH
Interventional Cardiology Physician 207RI0011X 11931 SD Primary

Addresses

Primary practice location

4520 W 69TH St
Sioux Falls, SD 57108-8148

Mailing address

4520 W 69TH St
Sioux Falls, SD 57108-8148
Phone (605) 977-5000

Other practice location 1

2301 Erwin Rd
Duke North Room 8241
Durham, NC 27705-4699
Phone (919) 681-2383

Other practice location 2

2301 Erwin Rd
Duke North Room 8241
Durham, NC 27705
Phone (919) 681-2383

Other identifiers 1

IdentifierTypeStateIssuer
1972879161MedicaidND

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD, IA, MN3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20200805000798 SD Practitioner - Internal MedicinePractitioner - Interventional Cardiology 5496003949 Reassigns benefits to 5 organizations
I20200812002287 IA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal MedicinePractitioner - Interventional Cardiology 5496003949 Reassigns benefits to 4 organizations
I20200814000442 MN Practitioner - Interventional Cardiology 5496003949 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
University of North Dakota School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1101 9TH St SE
NCH Sioux Center Medical Clinic
Sioux Center, IA 51250-2501
Phone (712) 722-2609

116 E 10TH St
Suite 101
Spencer, IA 51301-4365
Phone (712) 264-3500

1325 S Cliff Ave
Sioux Falls, SD 57105-1007

4500 W 69TH St
Sioux Falls, SD 57108-8148

4520 W 69TH St
Sioux Falls, SD 57108-8148
Phone (605) 977-5000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting226
Pacemaker insertion or repair1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Spencer Municipal Hospital Current Accepting new patients
Spencer Municipal Hospital CurrentSince Mar 23, 2021 Accepting new patients
Avera McKennan Current Accepting new patients
Avera Holy Family CurrentSince Aug 1, 2020 Accepting new patients
Wagner Community Memorial Hospital Current Accepting new patients
Avera Holy Family CurrentSince Aug 1, 2020 Accepting new patients
Avera Holy Family Current Accepting new patients
Heart Hospital of South Dakota LLC Cardiovascular Disease CurrentSince Aug 1, 2020 Accepting new patients
Wagner Community Memorial Hospital CurrentSince May 14, 2022 Accepting new patients
Regional Health Services of Howard County CurrentSince Apr 1, 2022 Accepting new patients
Avera McKennan CurrentSince Sep 1, 2020 Accepting new patients
Regional Health Services of Howard County CurrentSince Apr 1, 2022 Accepting new patients
Wagner Community Memorial Hospital CurrentSince May 14, 2022 Accepting new patients
Avera Gettysburg CurrentSince Apr 21, 2024 Accepting new patients
Avera McKennan CurrentSince Sep 1, 2020 Accepting new patients
Spencer Municipal Hospital CurrentSince Mar 23, 2021 Accepting new patients
Spencer Municipal Hospital Current Accepting new patients
Heart Hospital of South Dakota LLC Past Accepting new patients

Locations

235 8th Ave W
Cresco, IA 52136
Phone (319) 547-2101

826 N 8th St
Estherville, IA 51334
Phone (712) 362-2631

926 N 8th St
Estherville, IA 51334
Phone (712) 362-3501

116 E 11th St
Ste 101
Spencer, IA 51301
Phone (712) 264-3500

1200 1st Ave E
Spencer, IA 51301
Phone (712) 264-6164

300 S Bruce St
Marshall, MN 56258
Phone (507) 532-9631

606 E Garfield Ave
Ste C
Gettysburg, SD 57442
Phone (605) 765-2273

4520 W 69th St
Sioux Falls, SD 57108
Phone (605) 977-5000

Interoperability endpoints

  • Direct secure messaging: john.wagener@avera.sdhealthlink.net

Organizations & group practices 18

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.

View all 18

Hospital & facility affiliations 31

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

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1333238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596067200000",
    "number": "1972879161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4520 W 69TH ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571088148",
            "telephone_number": "605-977-5000",
            "fax_number": "605-977-5377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4520 W 69TH ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571088148",
            "telephone_number": "605-977-5000",
            "fax_number": "605-977-5377"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2301 Erwin Rd",
            "address_2": "Duke North Room 8241",
            "address_purpose": "LOCATION",
            "city": "Durham",
            "state": "NC",
            "postal_code": "277054699",
            "country_code": "US",
            "telephone_number": "919-681-2383",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2301 Erwin Rd",
            "address_2": "Duke North Room 8241",
            "address_purpose": "LOCATION",
            "city": "Durham",
            "state": "NC",
            "postal_code": "27705",
            "country_code": "US",
            "telephone_number": "919-681-2383",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAGENER",
        "first_name": "JOHN",
        "middle_name": "FRANCIS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-01",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OH",
            "license": "35.133649",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "SD",
            "license": "11931",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1972879161",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.