Stacy L Wagner, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

15-01553 Issued in KS

Practice address

1305 E 19TH Ave
Winfield, KS 67156-5201

Phone

(620) 221-9500

Fax

(620) 221-3700

NPI assigned

Aug 30, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in KS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bryan C Davis MD PAGroup PAC ID 0446246235, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Angels Care Home Health Home health agency, Chanute, KS, CCN 178060
• William Newton Hospital Hospital, Winfield, KS, CCN 171383
• SCK Health Hospital, Arkansas City, KS, CCN 170779

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Bryan C. Davis, M.D., P.a.

  • Family Medicine Physician
  • Winfield, KS
  • NPI 1235243023

  KS

  Medicare reassignment Care Compare group
• Arthritis and Rheumatology Clinics of Kansas LLC

  • Rheumatology Physician
  • Wichita, KS
  • NPI 1700881646

  KS

  Medicare reassignment
• Arthritis and Rheumatology Clinics of Kansas LLC

  • Durable Medical Equipment & Medical Supplies
  • Wichita, KS
  • NPI 1134016959
  NPD

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

• South Central Kansas Regional Medical Center

  • Rural Acute Care Hospital
  • Arkansas City, KS
  • NPI 1609842681

  Hospital

  Care Compare affiliation
• Wheatland Health Services, LLC

  • Home Health Agency
  • Chanute, KS
  • NPI 1275591760
  Care Compare affiliation
• William Newton Memorial Hospital

  • Critical Access Hospital
  • Winfield, KS
  • NPI 1548229149

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1346284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1992054431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 E 19TH AVE",
            "city": "WINFIELD",
            "state": "KS",
            "postal_code": "671565201",
            "telephone_number": "620-221-9500",
            "fax_number": "620-221-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 E 19TH AVE",
            "city": "WINFIELD",
            "state": "KS",
            "postal_code": "671565201",
            "telephone_number": "620-221-9500",
            "fax_number": "620-221-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "STACY",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-30",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": "15-01553",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "KS",
            "license": "15-01553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Urgent Care of Cowley County LLC
• Cassandra Lea Vandever Lund, PT
• Allison Rae Vannahmen, LPC
• Andrea Nicole Venn
• Linda Voth
• Wal-Mart Stores, Inc. Dba Wal-Mart
• Walmart Inc.
• Walnut Valley Foot and Ankle PA
• Walnut Valley Imaging PA
• Lynnetta F Ward, ARNP

• All providers in Winfield, KS
• Medical Physician Assistant in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.