Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1104598895 Individual Practitioner Male Practitioner

Kyle Alexander Wagner , PA-C

Physician Assistant • Fort Campbell, KY

Professional Overview & Biography Verified Profile Summary

Kyle Wagner, PA-C is a registered healthcare professional specializing in Physician Assistant in Fort Campbell, KY. Practice services are available at 650 JOEL DR under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

650 Joel Dr

Fort Campbell, KY 422235318

Telephone 8052068883
Associated Practice Facility / Clinic
🏢 Ach Blanchfield-Ft Campbell Facility NPI 1417044702

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Fort Campbell, KY

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 9.8 Yrs
State Avg: 12.7 Yrs
Regional Practice Density
133 Specialists

Practicing in Fort Campbell, KY (1973 Statewide)

Telehealth Adoption Rate
2.3% 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

CMS Verified: 2022-11-04
Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Tricare
1287412009

Practice Associates & Co-Workers

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

40 Associated Practitioners
Lisa Cordell , RN

Registered Nurse

NPI 1003134073

Registered Nurse

Samantha Winder , ATC

Specialist/Technologist - Athletic Trainer

NPI 1003143249

Certified Athletic Trainer

Kathleen Groff , FNP-BC

Nurse Practitioner

NPI 1003312984

Family Nurse Practitioner (Board Certified)

Lindsay Davis

Counselor - Professional

NPI 1003319799
Dr. Jeffrey Sanford , MD

Pathology - Anatomic Pathology & Clinical Pathology

NPI 1003470709

Doctor of Medicine (M.D.)

Erik Flolo , LMSW

Social Worker - Clinical

NPI 1003477605

Licensed Master Social Worker

Career & Practice History Timeline

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

8 Historical Events
👤
Provider Name / Credentials Updated November 04, 2022

Recorded as KYLE WAGNER, PA-C

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 04, 2022

Physician Assistant

NPI Profile Active September 30, 2021

NPI status registered as active in NPPES database

📍
Updated Practice Location September 30, 2021

Registered at 650 JOEL DR, FORT CAMPBELL, KY 422235318 (Tel: 8052068883)

📍
Updated Business Mailing Address September 30, 2021

Registered at 650 JOEL DR, FORT CAMPBELL, KY 422235318

👤
Provider Name / Credentials Updated September 30, 2021

Recorded as KYLE WAGNER, PA-S

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 30, 2021

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration September 30, 2021

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: 1104598895
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 30, 2021
Last Update: November 04, 2022
Sole Proprietor: Yes

Mailing Address

650 Joel Dr

Fort Campbell, KY 422235318

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

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.