IndividualActive
Mary Wagner
NPI 1093792822 · Family Medicine Physician · St Louis Park, MN
Mary Wagner is a Family Medicine Physician provider in St Louis Park, MN (NPI 1093792822).
Provider details
- NPI number
- 1093792822
- Entity type
- Individual
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Sex
- Female
- Sole proprietor
- No
- License
- 36748 (MN)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
6600 Excelsior Blvd
Ste 160
St Louis Park, MN 55426-4744
Phone: (952) 993-7707
Street-level locationGet directions
Mailing address
3800 Park Nicollet Blvd
Minneapolis, MN 55416-2527
Registry dates
- Enumerated
- 2005-12-22
- Last updated
- 2012-03-08
Frequently asked questions
- What is Mary Wagner's NPI number?
- Mary Wagner's National Provider Identifier (NPI) is 1093792822, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Mary Wagner's specialty?
- Mary Wagner is listed in the NPPES registry with a primary specialty of Family Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Mary Wagner located?
- Mary Wagner's practice location on file with NPPES is 6600 Excelsior Blvd, St Louis Park, MN 55426-4744.
- What is Mary Wagner's phone number?
- The practice phone number listed in the NPPES registry for Mary Wagner is (952) 993-7707.
- Is Mary Wagner's NPI active?
- Yes — Mary Wagner's NPI (1093792822) is active in the NPPES registry as of the last update on 2012-03-08.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.