Individual provider Active NPI

Aliyah Waggner

  • Family Nurse Practitioner
  • Addison, TX
National Provider Identifier
1104539071
Registry record updated Jan 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1105759 Issued in TX
Practice address
15301 Spectrum Dr
Addison, TX 75001-4665
Phone
(972) 661-2273
NPI assigned
Jan 5, 2023
Last updated
Jan 5, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1105759 TX Primary

Addresses

Primary practice location

15301 Spectrum Dr
Addison, TX 75001-4665

Mailing address

1212 Singleton Blvd Apt 1073
Dallas, TX 75212-5305
Phone (225) 938-6238

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230201000307 TX Practitioner - Nurse Practitioner 3375914229 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vpa of Texas PLLCGroup PAC ID 7618911660, 67 clinicians

Practice addresses (Care Compare)

Irving, TX 75038
Phone (972) 870-5511

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1105759TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Citra Physician Services PLLC CurrentSince Mar 5, 2024 Accepting new patients
Global Wound Care Medical Group CurrentSince May 28, 2024 Accepting new patients
Vpa of Texas PLLC CurrentSince Jan 6, 2026 Accepting new patients
Citra Physician Services PLLC CurrentSince Mar 5, 2024 Accepting new patients
Vpa of Texas PLLC CurrentSince Jan 6, 2026 Accepting new patients
Americare Medical Partners, PLLC Past Accepting new patients

Locations

5901 W Century Blvd
Ste 750
Los Angeles, CA 90045
Phone (323) 843-2861

18101 Preston Rd
Ste 201
Dallas, TX 75252
Phone (972) 533-8556

3414 Milton Ave
Dallas, TX 75205
Phone (214) 368-4822

2501 W 7th St
Ste 101
Ft Worth, TX 76107
Phone (817) 268-9690

2400 Augusta Dr
Ste 366
Houston, TX 77057
Phone (346) 362-5344

2400 Augusta Dr
Ste 369
Houston, TX 77057
Phone (323) 545-4007

4545 Fuller Dr
Ste 325
Irving, TX 75038
Phone (972) 870-5511

Organizations & group practices 8

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

NPI Registry JSON

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

{
    "created_epoch": "1672876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672876800000",
    "number": "1104539071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1212 SINGLETON BLVD APT 1073",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752125305",
            "telephone_number": "225-938-6238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15301 SPECTRUM DR",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750014665",
            "telephone_number": "972-661-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGGNER",
        "first_name": "ALIYAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-05",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1105759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Addison, TX

Sources for this page

Verify at the official NPI Registry.