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

Mariah M Wagner, PA-C

Individual provider Physician Assistant · NPI 1407329246

Mariah M Wagner, PA-C is a Physician Assistant in Johnson City, Tennessee. Graduated from Lincoln Memorial University Medical Department in 2018, 8 years ago. Practices with Regenerative Health and Chiropractic, Ltd, a 3-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Tennessee.

Years since qualifying
8
Trained at
Lincoln Memorial University Medical Department
Licensed in
TN
In the registry since
2019
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

2410 Susannah St
Johnson City, TN 37601-1748
Phone: (423) 282-9011
Fax: (423) 282-0035
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 340 Steeles Rd, Bristol, TN 37620 — (423) 282-9011
  • 875 Larry Neil Way, Kingsport, TN 37660-6368 — (423) 282-9011

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 3690 (TN)

Record details

NPI number1407329246
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJanuary 4, 2019
Last updated in NPPESOctober 14, 2020
Certification dateOctober 14, 2020

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolLINCOLN MEMORIAL UNIVERSITY MEDICAL DEPARTMENT
Graduated 2018 (8 years in practice)
Group practice Regenerative Health And Chiropractic, Ltd — 3 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Johnson City