AMY R WAGGNER (RN MSN FNP) – Nurse Practitioner, NPI 1861460537
Nurse Practitioner
Main info
Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
8,192 NURSE PRACTITIONER in IN
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Provider Addresses for AMY R WAGGNER (RN MSN FNP)
PO BOX 760
WASHINGTON, IN 475010760
Phone: (812) 254-7310
Type: Mailing
1402, Grand Avenue, Northwest Everett, Everett, Snohomish County, Washington, 98201, United States
WASHINGTON, IN 475012122
Phone: (812) 257-0383
Fax: (812) 257-0433
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 8 Open Payments records for all available years, with a total value of $140.
Total Amount is formed as General ($140) + Research ($0) + Ownership ($0) = $140.
Last reported payment date: 2024-11-15 • Largest payer in this snapshot: Corium, LLC ($65).
Total Amount
$140
General + Research + Ownership
Payments
8
Total payment records
General Amount
$140
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-15
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Corium, LLC | $65 |
| Ironshore Pharmaceuticals Inc. | $23 |
| SANOFI PASTEUR INC. | $21 |
| Tris Pharma Inc | $18 |
| Vertical Pharmaceuticals, LLC | $14 |
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: 2004-06-23
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 |
|---|---|---|---|---|
| I20040623001665 | I | Nurse Practitioner | IN | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 47501)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| A N E S T H E S I O L O G Y | IN | |
| Emergency Medicine | SC | |
| Internal Medicine | IN | |
| - | IN | |
| - | IN | |
| Nurse Practitioner | IN | |
| Clinical Social Worker | IN | |
| Nurse Practitioner | IN | |
| - | IN | |
| General Surgery | OH |
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