KELLY JO WAGNER
NPI 1861738981
Nurse Practitioner - Acute Care in Arvada, CO
About Kelly Jo Wagner NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KELLY JO WAGNER (NPI 1861738981) is an individual acute care provider in Arvada, Colorado, licensed in Colorado (0990570) and active in the NPI registry since December 2012. She is enrolled in Medicare PECOS and is a graduate of Other (2012).
NPPES Registry Identity
Specialties & Licenses
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
Kelly Jo Wagner 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 Reassignment
Medicare enrollment records show Kelly Wagner reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Arvada, CO 80004
- Reassigned Medicare billing, Colorado enrollment
- 78 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 4
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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 80004 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare 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 7
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
ARVADA, CO 80004
ARVADA, CO 80004
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 Kelly Wagner's NPI number?
The NPI number for Kelly Wagner is 1861738981. It was assigned to this individual provider in the NPPES registry on December 17, 2012.
Where is Kelly Wagner located?
Kelly Wagner practices at 12650 W 64th Ave Unit E501, Arvada, CO 80004. The listed phone number is (303) 431-4127.
What is Kelly Wagner's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.
Is Kelly Wagner enrolled in Medicare?
Yes. Kelly Wagner 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 organization bills Medicare for Kelly Wagner's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kelly Wagner reassigns Medicare benefits to Long Term Care And Rehab Consultants (Arvada, CO). The 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 Kelly Wagner's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Kelly Wagner was last updated on March 4, 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.
# Kelly Jo Wagner · NPI 1861738981
Acute Care physician in Arvada, Colorado. Individual provider, active in the CMS NPPES registry since December 17, 2012.
## Identity
- **NPI:** 1861738981 (Entity type: Individual)
- **Enumerated:** December 17, 2012
- **Primary specialty:** Nurse Practitioner - Acute Care · taxonomy 363LA2100X
- **State license:** 0990570 (Colorado)
- **Sole proprietor:** No
## Practice location
- **Address:** 12650 W 64TH AVE, UNIT E501, Arvada, CO 80004-3893
- **Phone:** (303) 431-4127 · **Fax:** (303) 431-4553
## 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:** Long Term Care And Rehab Consultants (NPI 1306946728, Arvada, CO), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2012
## Record status
- **NPPES last updated:** March 4, 2016
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Source: [NPI Profile](https://npiprofile.com/npi/1861738981) · Data from the CMS NPPES public registry.