MICHAEL WAYNE WAGONER (DO) – Family Medicine Physician, NPI 1902429749

MICHAEL WAYNE WAGONER (DO) is a healthcare provider. based in Celina, Texas. specializing in FAMILY PRACTICE. They hold the professional credentials DO. They hold a License No. T5488 (TX). The NPI Number for MICHAEL WAYNE WAGONER (DO) is 1902429749

Main info

Male
6 Years Of Experience
Accepts Medicare Assignment
Name
MICHAEL WAYNE WAGONER (DO)
NPI
1902429749
Phone
(757) 971-0190
Address
1109 AZURE LN
Enumeration Date
27 May 2020
Last Update Date
26 June 2024

Doctor Profile

Medical School Name
ALABAMA COLLEGE OF OSTEOPATHIC MEDICINE
Secondary Phone
9034161680
Graduation Year
2020 (6 years ago)
PAC ID
8921454422
Group Practice PAC ID
3678555307
Professional Enrollment ID
I20231019000989
Address ID
TX762731103WH308XXSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience41
Completeness75
Years active:6State licenses:1Digital endpointsOther names

8,705 FAMILY PRACTICE in TX

Provider Addresses for MICHAEL WAYNE WAGONER (DO)

  • 1109 AZURE LN

    CELINA, TX 750091798

    Phone: (757) 971-0190

    Type: Mailing

  • 809 GALLAGHER DR STE D

    SHERMAN, TX 750901754

    Phone: (903) 771-2846

    Fax: (903) 771-2849

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $17.

Total Amount is formed as General ($17) + Research ($0) + Ownership ($0) = $17.

Last reported payment date: 2023-07-06 • Largest payer in this snapshot: Exact Sciences Corporation ($17).

Total Amount

$17

General + Research + Ownership

Payments

1

Total payment records

General Amount

$17

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-07-06

Latest reported date

Top Companies

Largest payers in this snapshot

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: 2023-10-19

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
I20231019000989IFamily PracticeTXTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 75009)

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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: 3678555307View full group profile
NameSpecialtyState
Nurse PractitionerTX
Nurse PractitionerTX
Family PracticeTX
Family PracticeTX
Internal MedicineMO
Family PracticeTX
Family PracticeTX
-TX
Nurse PractitionerTX
Family PracticeTX

Reviews

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Frequently asked questions

What is the 10-digit NPI for MICHAEL WAYNE WAGONER (DO)?
MICHAEL WAYNE WAGONER (DO) — NPI 1902429749 — is the standard way to identify this listing.
Is MICHAEL WAYNE WAGONER (DO) still practicing?
MICHAEL WAYNE WAGONER (DO) is currently listed as active in the public NPI registry.
What taxonomy line describes MICHAEL WAYNE WAGONER (DO)?
For research purposes, treat MICHAEL WAYNE WAGONER (DO) as Family Medicine Physician in this dataset. Clinical services aligned with this taxonomy classification.
Where is MICHAEL WAYNE WAGONER (DO) based?
MICHAEL WAYNE WAGONER (DO) is tied to Celina, Texas in the data we show; additional addresses may exist on the full record.
How many locations tie to this NPI?
4 practice locations appear in the available data.

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