OrganizationActive
Wagoner Medical Center, LLC
NPI 1245458355 · Family Medicine Physician · Kokomo, IN
Provider details
- NPI number
- 1245458355
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Michelle Wagoner, Administrator(765) 566-3303
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Internal Medicine Physician207R00000X
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 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
2016 W Sycamore
Kokomo, IN 46901
Phone: (765) 566-3303
Street-level locationGet directions
Mailing address
605 E 7th Street
Burlington, IN 46915-0038
Registry dates
- Enumerated
- 2007-04-23
- Last updated
- 2009-05-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.