1. Home
  2. Directory
  3. Arkansas
  4. Lepanto
  5. Clinic Center
  6. NPI Profile

T W WAGNER INC
NPI 1114734969
Clinic/Center - Rural Health in Lepanto, AR

Active since December 16, 2024CLIA Certified · 3 labs
730 GREENWOOD AVE, LEPANTO, AR 72354(870) 475-3825 Get Directions Write a Review

NPPES record last updated: December 19, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About T W Wagner Inc NPPES

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

T W WAGNER INC (NPI 1114734969) is a healthcare organization registered as a rural health in Lepanto, Arkansas and active in the NPI registry since December 2024. The organization holds 3 active CLIA laboratory certificates and lists Tommy W Wagner, Owner/operator, as its authorized official.

NPPES Registry Identity

NPI1114734969
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameT W WAGNER INC
Location Address730 GREENWOOD AVELepanto, AR 72354-3215
Mailing AddressPo Box 910Manila, AR 72442-0910 · (870) 561-3300
Phone(870) 475-3825
Organization SubpartNo
Authorized OfficialTommy W WagnerOwner/operator · (870) 561-3300
Enumeration DateDecember 16, 2024
Last NPPES UpdateDecember 19, 2024
NPPES CertifiedDecember 19, 2024
✔ NPI 1114734969 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
Also ListedFamily MedicineTaxonomy 207Q00000X
730 GREENWOOD AVE, Lepanto, AR 72354
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 3

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 04D1055975

Wagner Medical Clinic · Lepanto, AR
Active · expires Jun 29, 2028
CLIA Number04D1055975
Laboratory TypePhysician Office
Certificate Effective DateJune 30, 2026
Certificate Expiration DateJune 29, 2028
Laboratory DirectorDr. Tommy W. Wagner
Laboratory Phone(870) 561-3300
Laboratory LocationWagner Medical Clinic730 Greenwood Ave, Lepanto, AR 72354
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 04D2113561

Wagner Medical Clinic · Blytheville, AR
Active · expires May 24, 2028
CLIA Number04D2113561
Laboratory TypePhysician Office
Certificate Effective DateMay 25, 2026
Certificate Expiration DateMay 24, 2028
Laboratory DirectorDr. Tommy W. Wagner
Laboratory Phone(870) 561-3300
Laboratory LocationWagner Medical Clinic1001 N 6th Street, Blytheville, AR 72315
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 04D1041996

Wagner Medical Clinic · Manila, AR
Active · expires Mar 10, 2028
CLIA Number04D1041996
Laboratory TypePhysician Office
Certificate Effective DateMarch 11, 2026
Certificate Expiration DateMarch 10, 2028
Laboratory DirectorDr. Tommy W. Wagner
Laboratory Phone(870) 561-3300
Laboratory LocationWagner Medical Clinic3644 West State Hwy 18, Manila, AR 72442
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

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

REGINA STROP CNP
Nurse Practitioner (Family)
730 GREENWOOD AVE
LEPANTO, AR 72354
Poinsett County (870) 475-3825
SOUTHERN HEALTH AND WELLNESS, INC
Pharmacy (Community/Retail Pharmacy)
730 GREENWOOD AVE, SUITE A
LEPANTO, AR 72354
Poinsett County (870) 475-2617

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 T W Wagner Inc's NPI number?

The NPI number for T W Wagner Inc is 1114734969. It was assigned to this organization in the NPPES registry on December 16, 2024.

Where is T W Wagner Inc located?

T W Wagner Inc is located at 730 Greenwood Ave, Lepanto, AR 72354. The listed phone number is (870) 475-3825.

What is T W Wagner Inc's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

Does T W Wagner Inc hold CLIA laboratory certificates?

Yes. 3 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for T W Wagner Inc was last updated on December 19, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months 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.