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GRACE ELIZABETH WAGNER DNP, APRN, CPNP
NPI 1871164418
Nurse Practitioner - Pediatrics in Peoria, IL

Active since July 06, 2021PECOS Enrolled
8600 STATE ROUTE 91 STE 200, PEORIA, IL 61615(309) 692-1030 Get Directions Write a Review

NPPES record last updated: July 6, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Grace Elizabeth Wagner Dnp, Aprn, Cpnp NPPES

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

GRACE ELIZABETH WAGNER DNP, APRN, CPNP (NPI 1871164418) is an individual pediatrics provider in Peoria, Illinois, licensed in Illinois (209021274) and active in the NPI registry since July 2021. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1871164418
Entity TypeIndividualFemale
Primary Taxonomy363LP0200X
Provider Legal NameGRACE ELIZABETH WAGNERCredential: DNP, APRN, CPNP
Location Address8600 STATE ROUTE 91 STE 200Peoria, IL 61615-7833
Mailing Address2223 Veterans Rd Unit 14Morton, IL 61550-4559 · (563) 676-5628
Phone(309) 692-1030
Sole ProprietorYes
Enumeration DateJuly 6, 2021
NPPES CertifiedJuly 6, 2021
✔ NPI 1871164418 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0200X
License✔ Licensed in IL · 209021274
8600 STATE ROUTE 91 STE 200, Peoria, IL 61615
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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)

Grace Elizabeth Wagner Dnp, Aprn, Cpnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 61615 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
$85.71 typical visit price
range $54.80 – $168.44
Typical copayment $21.42 (range $13.70 – $42.11)
Most-billed visit code 99203
Established Patient
$97.25 typical visit price
range $17.16 – $136.56
Typical copayment $24.31 (range $4.29 – $34.14)
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 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JESSICA N MISTRETTA DO
Pediatrics
8600 STATE ROUTE 91 STE 200
PEORIA, IL 61615
Peoria County (309) 692-1030
DR. TERRY HO M.D.
Pediatrics
8600 STATE ROUTE 91 STE 200
PEORIA, IL 61615
Peoria County (309) 692-1030

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 Grace Wagner's NPI number?

The NPI number for Grace Wagner is 1871164418. It was assigned to this individual provider in the NPPES registry on July 6, 2021.

Where is Grace Wagner located?

Grace Wagner practices at 8600 State Route 91 Ste 200, Peoria, IL 61615. The listed phone number is (309) 692-1030.

What is Grace Wagner's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

Is Grace Wagner enrolled in Medicare?

Yes. Grace Wagner is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Grace Wagner was last updated on July 6, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.