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

Nathan Andrew Wagner Sr., NP

Individual provider Family Nurse Practitioner · NPI 1649000183

Nathan Andrew Wagner Sr., NP is a Nurse Practitioner in Jackson, Mississippi. Graduated from University of Mississippi School of Medicine in 2024, 2 years ago. Practices with Mississippi Sports Medicine and Orthopaedic Center, a 73-clinician group and accepts Medicare assignment. Licensed in Mississippi.

Years since qualifying
2
Trained at
University of Mississippi School of Medicine
Licensed in
MS
In the registry since
2024
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

1325 E Fortification St
Jackson, MS 39202-2442
Phone: (601) 354-4488
Fax: (601) 351-5980
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 906801 (MS)

Record details

NPI number1649000183
Entity typeIndividual (Type 1)
GenderMale
Credentials NP
Sole proprietorNo
NPI enumeratedAugust 7, 2024
Last updated in NPPESAugust 7, 2024
Certification dateAugust 6, 2024

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolUNIVERSITY OF MISSISSIPPI SCHOOL OF MEDICINE
Graduated 2024 (2 years in practice)
Group practice Mississippi Sports Medicine And Orthopaedic Center — 73 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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