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

Jordan M Wagner, PA

Individual provider Family Medicine Physician · NPI 1831383074

Jordan M Wagner, PA is a Physician Assistant in Niles, Michigan. Qualified in 2007, 19 years ago. Practices with Lakeland Community Hospital Watervliet, a 65-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
19
Licensed in
MI
In the registry since
2007
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

2002 S 11th St
Niles, MI 49120-4074
Phone: (269) 687-0200
Fax: (269) 684-0199
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 5601005116 (MI)

Record details

NPI number1831383074
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedAugust 30, 2007
Last updated in NPPESMarch 14, 2013

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2007 (19 years in practice)
Group practice Lakeland Community Hospital Watervliet — 65 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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