Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Amanda Nicole Wagner, PA

Individual provider Physician Assistant · NPI 1043096142

Amanda Nicole Wagner, PA is a Physician Assistant in Gainesville, Georgia. Qualified in 2024, 2 years ago. Practices with Northeast Georgia Physicians Group Inc, a 892-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
2
Licensed in
GA
In the registry since
2023
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

743 Spring St NE
Gainesville, GA 30501-3715
Phone: (770) 219-9000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2129 Friendship Rd, Buford, GA 30519-2600 — (770) 715-5978

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 12940 (GA)

Record details

NPI number1043096142
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedSeptember 5, 2023
Last updated in NPPESSeptember 15, 2025
Certification dateSeptember 15, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Northeast Georgia Physicians Group Inc — 892 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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