SHANA L WAGNER (MSN, FNP-BC) – Family Nurse Practitioner, NPI 1699072140
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for SHANA L WAGNER (MSN, FNP-BC)
2920 SUPERIOR AVE
SHEBOYGAN, WI 530811944
Phone: (920) 457-2600
Fax: (920) 803-2990
Type: Mailing
W2850 STATE ROAD 28
SHEBOYGAN FALLS, WI 530852702
Phone: (920) 467-1800
Fax: (920) 467-1900
Type: Mailing
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.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2011-06-20
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20110620000639 | I | Nurse Practitioner | WI | 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 53081)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| NURSE PRACTITIONER | WI | 85610 | Blood test, clotting time | 18 | 15 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | WI | |
| Nurse Practitioner | WI | |
| Nurse Practitioner | WI | |
| Internal Medicine | WI | |
| Internal Medicine | WI | |
| - | WI | |
| Internal Medicine | WI | |
| Nurse Practitioner | WI | |
| H E M A T O L O G Y/ O N C O L O G Y | WI | |
| Internal Medicine | WI |
Reviews
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