MS. DARA MARIE WAGNER (APN-C) – Family Nurse Practitioner, NPI 1063046464
Family Nurse Practitioner
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
11,632 NURSE PRACTITIONER in IL
Provider Addresses for MS. DARA MARIE WAGNER (APN-C)
210 W WALNUT ST
CANTON, IL 615202444
Phone: (309) 647-5240
Type: Mailing
180 S MAIN ST
CANTON, IL 615202608
Phone: (309) 647-0201
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 27 Open Payments records for all available years, with a total value of $575.
Total Amount is formed as General ($575) + Research ($0) + Ownership ($0) = $575.
Last reported payment date: 2024-10-23 • Largest payer in this snapshot: ABBVIE INC. ($134).
Total Amount
$575
General + Research + Ownership
Payments
27
Total payment records
General Amount
$575
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-23
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $134 |
| AstraZeneca Pharmaceuticals LP | $86 |
| Astellas Pharma US Inc | $85 |
| Novo Nordisk Inc | $49 |
| Lilly USA, LLC | $39 |
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: 2021-09-21
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20210921003532 | I | Nurse Practitioner | IL | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 25 | 25 | $0 |
Insurance plans in this area (ZIP 61520)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | IL | |
| Nurse Practitioner | IL | |
| Diagnostic Radiology | IL | |
| Nurse Practitioner | IL | |
| Vascular Surgery | IL | |
| Diagnostic Radiology | IL | |
| Family Practice | IL | |
| Nurse Practitioner | IL | |
| Family Practice | ND | |
| Internal Medicine, Pediatric Medicine | IL |
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