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

Kelly Jo Wagner

Individual provider Acute Care Nurse Practitioner · NPI 1861738981

Kelly Jo Wagner is a Nurse Practitioner in Arvada, Colorado. Qualified in 2012, 14 years ago. Practices with Long Term Care and Rehab Consultants, a 59-clinician group and accepts Medicare assignment. Licensed in Colorado.

Years since qualifying
14
Licensed in
CO
In the registry since
2012
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Practice location Address checks out

12650 W 64th Ave Unit E501
Arvada, CO 80004-3893
Phone: (303) 431-4127
Fax: (303) 431-4553
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence 0990570 (CO)

Record details

NPI number1861738981
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedDecember 17, 2012
Last updated in NPPESMarch 4, 2016

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Long Term Care And Rehab Consultants — 59 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Arvada