DR. JACKSON WAGONER MD
NPI 1689137408
Anesthesiology - Pain Medicine in Casper, WY
About Dr. Jackson Wagoner Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. JACKSON WAGONER MD (NPI 1689137408) is an individual pain medicine provider in Casper, Wyoming, licensed in Wyoming (19414A) and active in the NPI registry since April 2019. He is enrolled in Medicare PECOS, is affiliated with Campbell County Health, and maintains 3 additional practice locations.
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Locations 3
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Jackson Wagoner Md 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.
Medicare Billing Reassignments
3Medicare enrollment records show Jackson Wagoner reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Casper, WY 82609
- Reassigned Medicare billing, Wyoming enrollment
- 38 clinicians in this Medicare group
Laramie, WY 82070
- Reassigned Medicare billing, Wyoming enrollment
- Also billed through NPI 1366412397 (Wyoming)
- 2 clinicians in this Medicare group
Gainesville, FL 32610
- Reassigned Medicare billing, Florida enrollment
- 3,324 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims
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.
Hospital Affiliations CMS Care Compare 5
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Campbell County Health
Acute Care Hospitals · Gillette, WYSagewest Health Care
Acute Care Hospitals · Riverton, WYSummit Medical Center
Acute Care Hospitals · Casper, WYMemorial Hospital Of Converse County
Critical Access Hospitals · Douglas, WYPlatte County Memorial Hospital
Critical Access Hospitals · Wheatland, WYMedicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Other Providers at the Same Location NPPES 12
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
CASPER, WY 82601
CASPER, WY 82601
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 Jackson Wagoner's NPI number?
The NPI number for Jackson Wagoner is 1689137408. It was assigned to this individual provider in the NPPES registry on April 9, 2019.
Where is Jackson Wagoner located?
Jackson Wagoner practices at 1541 Diamond Dr, Casper, WY 82601. The listed phone number is (307) 439-1097.
What is Jackson Wagoner's specialty?
The primary specialty registered for this NPI is Anesthesiology, specializing in Pain Medicine, with taxonomy code 207LP2900X.
Is Jackson Wagoner enrolled in Medicare?
Yes. Jackson Wagoner is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Jackson Wagoner's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jackson Wagoner reassigns Medicare benefits to 3 organizations: Summit Memorial Medical Group LLC (Casper, WY), Gem City Bone & Joint (Laramie, WY) and Florida Clinical Practice Association Inc (Gainesville, FL). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jackson Wagoner's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Jackson Wagoner accept?
Health plans from Blue Cross Blue Shield of Wyoming list Jackson Wagoner as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
Is Jackson Wagoner affiliated with any hospitals?
According to CMS data, Jackson Wagoner is affiliated with Campbell County Health, Sagewest Health Care, Summit Medical Center, Memorial Hospital Of Converse County and Platte County Memorial Hospital.
When was this NPI record last updated?
The NPPES record for Jackson Wagoner was last updated on April 8, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.
# Dr. Jackson Wagoner, MD · NPI 1689137408
Pain Medicine physician in Casper, Wyoming. Individual provider, active in the CMS NPPES registry since April 9, 2019.
## Identity
- **NPI:** 1689137408 (Entity type: Individual)
- **Enumerated:** April 9, 2019
- **Primary specialty:** Anesthesiology - Pain Medicine · taxonomy 207LP2900X
- **State license:** 19414A (Wyoming)
- **Sole proprietor:** No
## Practice location
- **Address:** 1541 DIAMOND DR, Casper, WY 82601-6247
- **Phone:** (307) 439-1097
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): Summit Memorial Medical Group LLC (NPI 1598469462, Casper, WY); Gem City Bone & Joint (NPI 1558585737, Laramie, WY); Florida Clinical Practice Association Inc (NPI 1063463768, Gainesville, FL) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Nebraska College Of Medicine, class of 2019
## Record status
- **NPPES last updated:** April 8, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1689137408) · Data from the CMS NPPES public registry.