MRS. KATHRYN JANE WAGNER (FNP-C) – Nurse Practitioner, NPI 1750806097

MRS. KATHRYN JANE WAGNER (FNP-C) is a healthcare provider. based in Livonia, Michigan. specializing in Nurse Practitioner. They hold the professional credentials FNP-C. They hold a License No. 4704301133 (MI). The NPI Number for MRS. KATHRYN JANE WAGNER (FNP-C) is 1750806097

Main info

Female
9 Years Of Experience
Accepts Medicare Assignment
Name
MRS. KATHRYN JANE WAGNER (FNP-C)
NPI
1750806097
Phone
(248) 762-5915
Address
29911 6 MILE RD
Enumeration Date
8 August 2017
Last Update Date
16 March 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2485412512
Graduation Year
2017 (9 years ago)
PAC ID
1850665407
Group Practice PAC ID
4981849320
Professional Enrollment ID
I20170920000917

Contacts

Secure Messaging
kmessmore782994@direct.beaumont.edu
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience45
Completeness85
Years active:8State licenses:1Other namesUpdated within 12 months

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Provider Addresses for MRS. KATHRYN JANE WAGNER (FNP-C)

  • 6 Mile Road, Livonia, Wayne County, Michigan, 48239, United States

    LIVONIA, MI 481523603

    Phone: (248) 762-5915

    Type: Location

  • 29911 6 Mile Rd

    Livonia, MI 481523603

    Phone: (248) 762-5915

    Type: Location

  • 28050 GRAND RIVER AVE

    FARMINGTON HILLS, MI 483365919

    Phone: (248) 798-3107

    Type: Location

  • East 14 Mile Road, Sterling Heights, Macomb County, Michigan, 48312, United States

    STERLING HEIGHTS, MI 483126304

    Phone: (586) 977-3900

    Fax: (586) 977-6084

    Type: Mailing

  • 26901 BEAUMONT BLVD STE 3D

    SOUTHFIELD, MI 480333849

    Phone:

    Fax: (586) 977-6084

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 3 Open Payments records for all available years, with a total value of $1,750.

Total Amount is formed as General ($1,750) + Research ($0) + Ownership ($0) = $1,750.

Last reported payment date: 2024-01-19 • Largest payer in this snapshot: Intuitive Surgical, Inc. ($1,750).

Total Amount

$1,750

General + Research + Ownership

Payments

3

Total payment records

General Amount

$1,750

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-01-19

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Intuitive Surgical, Inc.$1,750
View all Open Payments →|Open Payments Risk Radar →

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: 2017-09-20

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
I20170920000917INurse PractitionerMITBD

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 minutes1515$0
View full utilization report →

Insurance plans in this area (ZIP 48152)

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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: 4981849320View full group profile
NameSpecialtyState
Internal MedicineMI
Physician AssistantMI
Internal MedicineMI
Internal MedicineMI

Reviews

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Frequently asked questions

What is the 10-digit NPI for MRS. KATHRYN JANE WAGNER (FNP-C)?
MRS. KATHRYN JANE WAGNER (FNP-C) — NPI 1750806097 — is the standard way to identify this listing.
Is MRS. KATHRYN JANE WAGNER (FNP-C) still practicing?
MRS. KATHRYN JANE WAGNER (FNP-C) is currently listed as active in the public NPI registry.
What is MRS. KATHRYN JANE WAGNER (FNP-C)'s primary classification?
Nurse Practitioner is the headline specialty for MRS. KATHRYN JANE WAGNER (FNP-C) here. Clinical services aligned with this taxonomy classification.
Where should I expect MRS. KATHRYN JANE WAGNER (FNP-C) on a map?
Expect Livonia, Michigan as a primary anchor for MRS. KATHRYN JANE WAGNER (FNP-C) unless the record lists multiple sites.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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