MELISSA DALTON WAGNER (APRN) – Family Nurse Practitioner, NPI 1174992382
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
7,347 NURSE PRACTITIONER in KY
Provider Addresses for MELISSA DALTON WAGNER (APRN)
PO BOX 697
PRESTONSBURG, KY 416530697
Phone: (606) 298-2520
Fax: (606) 298-2522
Type: Mailing
64 KIRK PLZ
INEZ, KY 41224
Phone: (606) 298-2520
Fax: (606) 298-2522
Type: Location
125 S MAIN CROSS ST
LOUISA, KY 412301065
Phone: (606) 638-0938
Type: Mailing
34 MEDICAL PARK BLVD
PETERSBURG, VA 238059283
Phone: (804) 609-0175
Fax: (804) 835-5999
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $41.
Total Amount is formed as General ($41) + Research ($0) + Ownership ($0) = $41.
Last reported payment date: 2024-03-15 • Largest payer in this snapshot: ABBVIE INC. ($41).
Total Amount
$41
General + Research + Ownership
Payments
2
Total payment records
General Amount
$41
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-03-15
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $41 |
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: 2025-12-23
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
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 |
|---|---|---|---|---|
| I20160810000772 | I | Nurse Practitioner | KY | TBD |
| I20251124003033 | I | Nurse Practitioner | VA | TBD |
| I20251223003881 | I | Nurse Practitioner | OH | 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 41653)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | VA | |
| Addiction Medicine, Internal Medicine, Pediatric Medicine | TN | |
| Nurse Practitioner | VA | |
| Nurse Practitioner | VA |
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