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MR. BRIAN GEORGE WAGONER RN FNP BC NPI 1306083480


NPI Information

NPI: 1306083480
Provider Name: MR. BRIAN GEORGE WAGONER, RN, FNP BC
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Organization: MERCY CLINIC SPRINGFIELD COMMUNITIES

PECOS Registration: Yes

Address:
1235 E CHEROKEE ST
SPRINGFIELD, MO
ZIP 65804
Phone: (417) 820-9729
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MR. Brian George Wagoner, RN, FNP BC is a family nurse practitioner in Springfield, MO with 16 years of experience. MR. Brian George Wagoner, RN, FNP BC NPI is 1306083480. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1235 E CHEROKEE ST
SPRINGFIELD, MO
ZIP 65804-203
Phone: (417) 820-9729
Fax: (417) 820-6471

The NPI 1306083480 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Ultrasonic guidance imaging supervision and interpretation for insertion of needle (HCPCS:76942)
  • Fluoroscopic guidance for insertion, replacement or removal of central venous access device (HCPCS:77001)
  • Ultrasound guidance for accessing into blood vessel (HCPCS:76937)

The enumeration date for this NPI number is 1/12/2009 and was last updated on 6/10/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363LF0000XNurse PractitionerFamily155580MISSOURIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1PENDINGMEDICAIDMISSOURI
2PENDINGMEDICARE PINMISSOURI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.