KELLY JO WAGNER – Acute Care Nurse Practitioner, NPI 1861738981

KELLY JO WAGNER is a healthcare provider. based in Arvada, Colorado. specializing in NURSE PRACTITIONER. They hold a License No. 0990570 (CO). The NPI Number for KELLY JO WAGNER is 1861738981

Main info

Female
14 Years Of Experience
Accepts Medicare Assignment
Name
KELLY JO WAGNER
NPI
1861738981
Phone
(937) 243-1014
Address
6595 ZINNIA ST
Enumeration Date
17 December 2012
Last Update Date
4 March 2016

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3034277101
Graduation Year
2012 (14 years ago)
PAC ID
9638324114
Group Practice PAC ID
5294733861
Professional Enrollment ID
I20130307000258
Address ID
CO800304818WE7481XPLXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience40
Completeness75
Years active:13State licenses:1Digital endpointsOther names

5,201 NURSE PRACTITIONER in CO

Provider Addresses for KELLY JO WAGNER

  • 6595 ZINNIA ST

    ARVADA, CO 800042256

    Phone: (937) 243-1014

    Type: Mailing

  • 12650 W 64TH AVE

    UNIT E501

    ARVADA, CO 800043893

    Phone: (303) 431-4127

    Fax: (303) 431-4553

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2013-03-07

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20130307000258INurse PractitionerCOTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes11970$0
99231Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes8952$0
99233Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes2823$0
99239Hospital discharge day management, more than 30 minutes1414$0
View full utilization report →

Insurance plans in this area (ZIP 80004)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5294733861View full group profile
NameSpecialtyState
Nurse PractitionerCO
Nurse PractitionerTN
Nurse PractitionerCO
Nurse PractitionerCO
Physician AssistantCO
Nurse PractitionerCO
Nurse PractitionerCO
Nurse PractitionerCO
Geriatric MedicineCO
Nurse PractitionerCO

Reviews

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Frequently asked questions

What is the standard ID for KELLY JO WAGNER in the U.S.?
In the U.S., KELLY JO WAGNER is identified by NPI 1861738981.
Is KELLY JO WAGNER currently accepting referrals based on NPI status?
Registry metadata lists KELLY JO WAGNER as active.
What does the directory say KELLY JO WAGNER does?
Insurance directories may phrase it differently, but here KELLY JO WAGNER maps to Acute Care Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What geographic area is tied to KELLY JO WAGNER?
KELLY JO WAGNER is associated with Arvada, Colorado in the same public data insurers reference.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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