KRISTA TERESE WAGONER M.D.
NPI 1619238359
Obstetrics & Gynecology in Charleston, SC

Q: What is Krista Wagoner's NPI number?

The NPI number for Krista Wagoner is 1619238359. It was assigned to this individual provider in the NPPES registry on May 30, 2012.

Q: What is Krista Wagoner's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Q: When was this NPI record last updated?

The NPPES record for Krista Wagoner was last updated on June 17, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.

Active since May 30, 2012PECOS EnrolledAccepts Medicare Assignment

171 ASHLEY AVE, CHARLESTON, SC 29425(843) 792-7108 Get Directions Write a Review

NPPES record last updated: June 17, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Krista Terese Wagoner M.d. NPPES

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

KRISTA TERESE WAGONER M.D. (NPI 1619238359) is an individual obstetrics & gynecology provider in Charleston, South Carolina, licensed in South Carolina (LL 34683) and active in the NPI registry since May 2012. She is enrolled in Medicare PECOS, is affiliated with Musc Medical Center, and is a graduate of Other (2012).

NPPES Registry Identity

NPI1619238359

Entity TypeIndividualFemale

Primary Taxonomy207V00000X

Provider Legal NameKRISTA TERESE WAGONERCredential: M.D.

Location Address171 ASHLEY AVECharleston, SC 29425-8908

Mailing AddressPo Box 751461Charlotte, NC 28275-1461 · (843) 792-6200

Phone(843) 792-7108

Sole ProprietorNo

Medical School CMSOtherGraduated 2012

Enumeration DateMay 30, 2012

Last NPPES UpdateJune 17, 2016

✔ NPI 1619238359 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians

Taxonomy Code207V00000X

License✔ Licensed in SC · LL 34683

Definition

An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

171 ASHLEY AVE, Charleston, SC 29425

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BlueCross BlueShield of South Carolina, First Choice Next, Molina Healthcare and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Krista Terese Wagoner M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4789985631

PECOS Enrollment IDI20160802001587

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

31 services26 patients

Cervical or vaginal cancer screening; pelvic and clinical breast examination G0101

This procedure involves checking for health issues in the lower abdomen and chest area. It helps identify early signs of certain conditions, increasing the chance for successful treatment. It's a routine check-up that's important for maintaining good health.

12 services12 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Musc Medical Center

Acute Care Hospitals · Charleston, SC

2/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number420004

Location169 Ashley AveCharleston, SC 29425 · Charleston County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 29425 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$124.04 typical visit price

range $53.57 – $163.84

Typical copayment $31.01 (range $13.39 – $40.96)

Most-billed visit code 99204

Established Patient

$67.12 typical visit price

range $16.96 – $133.52

Typical copayment $16.78 (range $4.24 – $33.38)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

CAROLYN REED WORD M.D.

Allergy & Immunology