DOUGLAS LEE WAGONER (MD) – Family Medicine Physician, NPI 1225027162

DOUGLAS LEE WAGONER (MD) is a healthcare provider. based in Glencoe, Minnesota. specializing in Family Medicine Physician. They hold the professional credentials MD. They hold a License No. 27782 (MN). The NPI Number for DOUGLAS LEE WAGONER (MD) is 1225027162

Main info

Male
48 Years Of Experience
Accepts Medicare Assignment
Name
DOUGLAS LEE WAGONER (MD)
NPI
1225027162
Phone
(320) 864-3121
Address
1805 HENNEPIN AVE N
Enumeration Date
13 October 2005
Last Update Date
25 November 2020

Doctor Profile

Medical School Name
UNIVERSITY OF IOWA, RJ & L CARVER COLLEGE OF MEDICINE
Secondary Phone
3208643121
Graduation Year
1978 (48 years ago)
PAC ID
4486566965
Group Practice PAC ID
1759292980
Professional Enrollment ID
I20100215000796

Contacts

Secure Messaging
dwagoner83502@excellian.direct.allina.com
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness85
Years active:20State licenses:1Other namesUpdated within 12 months

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Provider Addresses for DOUGLAS LEE WAGONER (MD)

  • Glencoe Regional Health Services, 1805, Hennepin Avenue North, Perez Mobile Home Park, Glencoe, McLeod County, Minnesota, 55336, United States

    GLENCOE, MN 553361416

    Phone: (320) 864-3121

    Fax: (320) 864-7887

    Mailing address matches the actual address.

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.

No Medicare enrollment or revalidation data available for this provider in our database.

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 55336)

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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: 1759292980View full group profile
NameSpecialtyState
Orthopedic SurgeryOK
Physician AssistantMN
Emergency MedicineMN
Family PracticeMN
Family PracticeMN
Nurse PractitionerMN
Orthopedic SurgeryMN
Certified Registered Nurse Anesthetist (Crna)MN
Certified Registered Nurse Anesthetist (Crna)MN
Certified Registered Nurse Anesthetist (Crna)MN

Reviews

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Frequently asked questions

Does DOUGLAS LEE WAGONER (MD) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — DOUGLAS LEE WAGONER (MD) uses 1225027162.
Does CMS list DOUGLAS LEE WAGONER (MD) as active?
Yes — DOUGLAS LEE WAGONER (MD) is active in the NPI listing used on this page.
What taxonomy line describes DOUGLAS LEE WAGONER (MD)?
For research purposes, treat DOUGLAS LEE WAGONER (MD) as Family Medicine Physician in this dataset. Clinical services aligned with this taxonomy classification.
What area does DOUGLAS LEE WAGONER (MD) serve?
DOUGLAS LEE WAGONER (MD)'s listing highlights Glencoe, Minnesota; more addresses can appear in NPPES.
Why does DOUGLAS LEE WAGONER (MD) have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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