Pamela Coy Wagner, RN, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2006004567-22 Issued in TX

Practice address

102 Springwood Dr
Victoria, TX 77904-3501

Phone

(361) 576-2222

NPI assigned

Oct 31, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

Practice roles

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.

• Abk Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Alice, TX
  • NPI 1801983036
  NPD (past)
• Twin Fountains Urgent Care Center

  • Internal Medicine Physician
  • Victoria, TX
  • NPI 1598078453
  NPD (past)

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1992881064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 SPRINGWOOD DR",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779043501",
            "telephone_number": "361-579-4961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 SPRINGWOOD DR",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779043501",
            "telephone_number": "361-576-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "PAMELA",
        "middle_name": "COY",
        "name_prefix": "Mrs.",
        "credential": "RN, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-31",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "2006004567-22",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Renee Wachsmuth, R.PH.
• Christine Mary Wagner, LCSW
• Derrick C Wagner, FNP-C
• Donna RM Wagner, M.D.
• Erin Leigh Wagner
• William Jordan Wagner Jr., M.D.
• Loren C Wakham, O.D.
• Wal-Mart Stores Texas LLC
• Wal-Mart Stores Texas LLC
• Wal-Mart Stores Texas, LLC

• All providers in Victoria, TX
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.