WILLIAM WAGONER FNP
NPI 1710854252
Nurse Practitioner in Fairmont, WV

Q: 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.

Q: What is William Wagoner's specialty?

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

Q: 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 12 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.

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: October 25, 2026.

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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, is affiliated with West Virginia University Hospitals, Inc, 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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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

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.

Medicare Billing Reassignment

Medicare enrollment records show William Wagoner reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Monongahela Valley Association Of Health Centers, Inc

Same address

Federally Qualified Health Center (FQHC)

1322 LOCUST AVE
Fairmont, WV 26554

Reassigned Medicare billing, West Virginia enrollment
19 clinicians in this Medicare group

NPI 1770697278 (304) 366-0700

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Hospital Affiliations CMS Care Compare

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

West Virginia University Hospitals, Inc

Acute Care Hospitals · Morgantown, WV

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number510001

Location1 Medical Center DriveMorgantown, WV 26506 · Monongalia County

Emergency services Birthing friendly

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)