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WILLIAM WAGONER FNP
NPI 1710854252
Nurse Practitioner in Fairmont, WV

Active since October 20, 2025PECOS Enrolled
1322 LOCUST AVE, FAIRMONT, WV 26554(304) 366-0700 Get Directions Write a Review

NPPES record last updated: October 20, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About William Wagoner Fnp NPPES

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

WILLIAM WAGONER FNP (NPI 1710854252) is an individual nurse practitioner in Fairmont, West Virginia, licensed in West Virginia (124345) and active in the NPI registry since October 2025. He is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1710854252
Entity TypeIndividualMale
Primary Taxonomy363L00000X
Provider Legal NameWILLIAM WAGONERCredential: FNP
Location Address1322 LOCUST AVEFairmont, WV 26554-1436
Mailing Address107 Cowell StWestover, WV 26501-3809
Phone(304) 366-0700
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateOctober 20, 2025
NPPES CertifiedOctober 20, 2025
✔ NPI 1710854252 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in WV · 124345
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
1322 LOCUST AVE, Fairmont, WV 26554
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

William Wagoner Fnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1759874647
PECOS Enrollment IDI20251129000207
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 26554 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
$83.49 typical visit price
range $53.20 – $164.59
Typical copayment $20.87 (range $13.30 – $41.14)
Most-billed visit code 99203
Established Patient
$94.81 typical visit price
range $16.47 – $133.29
Typical copayment $23.70 (range $4.11 – $33.32)
Most-billed visit code 99214
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.

SARIAH DALE WALDRON
Nurse Practitioner (Primary Care)
1322 LOCUST AVE
FAIRMONT, WV 26554
Marion County (304) 366-0700
THERESE DANIELLE REED FNP-C
Nurse Practitioner (Family)
1322 LOCUST AVE
FAIRMONT, WV 26554
Marion County (304) 366-0700
KANDY ANNTONETTE FITCH R.PH.
Pharmacist
1322 LOCUST AVE
FAIRMONT, WV 26554
Marion County (304) 366-0700
MS. RUBINA K DASILVA PAC
Physician Assistant
1322 LOCUST AVE
FAIRMONT, WV 26554
Marion County (304) 366-0700
MVA X-RAY FAIRMONT CLINIC
Clinic/Center (Radiology)
1322 LOCUST AVE
FAIRMONT, WV 26554
Marion County (304) 366-0700
DR. RYAN CHRISTOPHER HALL M.D.
Internal Medicine
1322 LOCUST AVE
FAIRMONT, WV 26554
Marion County (304) 366-0700
MS. ANNE E EVERLY PHARMACIST
Pharmacist
1322 LOCUST AVE
FAIRMONT, WV 26554
Marion County (304) 366-0700
DR. AGNES MARIE FRANZ MD
Pediatrics
1322 LOCUST AVE
FAIRMONT, WV 26554
Marion County (304) 366-0700

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 William Wagoner's NPI number?

The NPI number for William Wagoner is 1710854252. It was assigned to this individual provider in the NPPES registry on October 20, 2025.

Where is William Wagoner located?

William Wagoner practices at 1322 Locust Ave, Fairmont, WV 26554. The listed phone number is (304) 366-0700.

What is William Wagoner's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is William Wagoner enrolled in Medicare?

Yes. William Wagoner is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for William Wagoner was last updated on October 20, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.