KYLE ALEXANDER WAGNER PA-C
NPI 1104598895
Physician Assistant in Fort Campbell, KY

Active since September 30, 2021
650 JOEL DR, FORT CAMPBELL, KY 42223(805) 206-8883 Get Directions Write a Review

NPPES record last updated: November 4, 2022. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Nov 4, 2022, Sep 30, 2021 (2 updates tracked since 2021).

About Kyle Alexander Wagner Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KYLE ALEXANDER WAGNER PA-C (NPI 1104598895) is an individual physician assistant in Fort Campbell, Kentucky and active in the NPI registry since September 2021.

NPPES Registry Identity

NPI1104598895
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameKYLE ALEXANDER WAGNERCredential: PA-C
Location Address650 JOEL DRFort Campbell, KY 42223-5318
Mailing Address650 Joel DrFort Campbell, KY 42223-5318
Sole ProprietorYes
Enumeration DateSeptember 30, 2021
Last NPPES UpdateNovember 4, 20222 updates tracked since enumeration
NPPES CertifiedNovember 4, 2022
NPI 1104598895 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
650 JOEL DR, Fort Campbell, KY 42223

Other Identifiers 1

Other1287412009Tricare

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Registered Nurse
650 JOEL DR
FORT CAMPBELL, KY 42223
Specialist/Technologist (Athletic Trainer)
650 JOEL DR
FORT CAMPBELL, KY 42223
Military Hospital
650 JOEL DR
FORT CAMPBELL, KY 42223
Nurse Practitioner
650 JOEL DR
FORT CAMPBELL, KY 42223
Counselor (Professional)
650 JOEL DR
FORT CAMPBELL, KY 42223
Pathology (Anatomic Pathology & Clinical Pathology)
650 JOEL DR
FORT CAMPBELL, KY 42223
Social Worker (Clinical)
650 JOEL DR
FORT CAMPBELL, KY 42223
Pathology (Anatomic Pathology & Clinical Pathology)
650 JOEL DR
FORT CAMPBELL, KY 42223

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kyle Wagner's NPI number?

The NPI number for Kyle Wagner is 1104598895. It was assigned to this individual provider in the NPPES registry on September 30, 2021.

Where is Kyle Wagner located?

Kyle Wagner practices at 650 Joel Dr, Fort Campbell, KY 42223. The listed phone number is (805) 206-8883.

What is Kyle Wagner's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

When was this NPI record last updated?

The NPPES record for Kyle Wagner was last updated on November 4, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.