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Active NPI 1114202421 Individual Practitioner Female Practitioner

Lori J Wagner , FNP

Nurse Practitioner - Pediatrics • Phoenix, AZ

Professional Overview & Biography Verified Profile Summary

Lori Wagner, FNP is a registered healthcare professional specializing in Nurse Practitioner - Pediatrics in Phoenix, AZ. Practice services are available at 1919 E THOMAS RD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1919 E Thomas Rd

Phoenix, AZ 850167710

Telephone 6029330920
Fax 6029332492
Associated Practice Facility / Clinic
🏢 Phoenix Children's Hospital Facility NPI 1760480503

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner - Pediatrics in Phoenix, AZ

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 9.8 Yrs
State Avg: 11.9 Yrs
Regional Practice Density
244 Specialists

Practicing in Phoenix, AZ (443 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Nurse Practitioner - Pediatrics Primary Specialty

NUCC Taxonomy Code: 363LP0200X

State License AZ AP4240

Definition to come...

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
668941 (AZ)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Glenn Grushko , PNP

Nurse Practitioner - Pediatrics

NPI 1023995164

Pediatric Nurse Practitioner

Bianca Roman , PNP

Nurse Practitioner - Pediatrics

NPI 1053824532

Pediatric Nurse Practitioner

Dr. Holly Miller , DO

Pediatrics - Pediatric Hematology-Oncology

NPI 1083841191

Doctor of Osteopathic Medicine (D.O.)

Dr. Natasha Bala , MD

Pediatrics - Pediatric Hematology-Oncology

NPI 1093247678

Doctor of Medicine (M.D.)

Sheila O'donnell , FNP

Nurse Practitioner - Family

NPI 1154847309

Family Nurse Practitioner

Dr. Laura Retson , DO

Pediatrics - Pediatric Hematology-Oncology

NPI 1215478664

Doctor of Osteopathic Medicine (D.O.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
📍
Updated Business Mailing Address March 30, 2018

Registered at 3200 E CAMELBACK RD STE 250, PHOENIX, AZ 850182327 (Tel: 6029331814)

NPI Profile Active January 11, 2013

NPI status registered as active in NPPES database

📍
Updated Practice Location January 11, 2013

Registered at 1919 E THOMAS RD, PHOENIX, AZ 850167710 (Tel: 6025460920)

📍
Updated Business Mailing Address January 11, 2013

Registered at 1919 E THOMAS RD, BLDG 2108, SUITE 101, PHOENIX, AZ 850167710 (Tel: 6025128030)

👤
Provider Name / Credentials Updated January 11, 2013

Recorded as LORI WAGNER, FNP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 11, 2013

Nurse Practitioner (License #AP4240 in AZ)

🟢
Initial NPI Registration & Enumeration October 18, 2011

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1114202421
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 18, 2011
Last Update: March 30, 2018
Sole Proprietor: No

Mailing Address

3200 E Camelback Rd Ste 250

Phoenix, AZ 850182327

Phone: 6029331814

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

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