Amber Leia Waggoner, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1145675 Issued in TX

Practice address

2413 Memorial Pkwy
Portland, TX 78374-3209

Phone

(361) 643-4546

Fax

(361) 758-2137

NPI assigned

Dec 21, 2023

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Wellmed Medical Group PAGroup PAC ID 4880657386, 666 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amber.waggoner@wellmed.eclinicaldirectplus.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Wellmed Medical Group, PA

  • Internal Medicine Physician
  • San Antonio, TX
  • NPI 1437156486

  TX

  Medicare reassignment Care Compare group NPD
• Wellmed Medical Group, P.a.

  • Family Medicine Physician
  • Corpus Christi, TX
  • NPI 1740588243
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1703116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765843200000",
    "number": "1083483713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2413 MEMORIAL PKWY",
            "city": "PORTLAND",
            "state": "TX",
            "postal_code": "783743209",
            "telephone_number": "361-643-4546",
            "fax_number": "361-758-2137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2413 MEMORIAL PKWY",
            "city": "PORTLAND",
            "state": "TX",
            "postal_code": "783743209",
            "telephone_number": "361-643-4546",
            "fax_number": "361-758-2137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGGONER",
        "first_name": "AMBER",
        "middle_name": "LEIA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-21",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1145675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isabella A Vasconcelos, COTA
• Sandra L Vasquez, RDH
• Veena Dental
• Madison Ann Villarreal, MSN, APRN, FNP-BC
• Julie Marie Volz, RPH
• Wal-Mart Stores Texas LLC
• Wal-Mart Stores Texas, LLC
• Walgreen Co
• Teri Dona Warner, LMT
• Wavefront Eyecare & Optical PA

• Family Nurse Practitioner in Portland, TX
• Providers in Portland, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.