Active NPI
Norman S. Waggy, MD
- Family Medicine Physician
- Middlebury, IN
National Provider Identifier
1104847664
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 01030282A
- Practice address
- 206 W. Warren Street
Middlebury, IN 46540-0459 - Phone
- (574) 825-2146
- Fax
- (574) 825-2182
- NPI assigned
- Jul 21, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 01030282A | IN | Primary |
Addresses
Primary practice location
206 W. Warren Street
Middlebury, IN 46540-0459
Mailing address
PO Box 459
Middlebury, IN 46540-0459
Phone (574) 825-2146
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100361050A | Medicaid | IN | |
| 100361050B | Medicaid | IN | |
| 080025301 | Other | IN | R/R MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01030282A | IN | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Middlebury Family Physicians, Inc | Family Medicine | Past | Accepting new patients |
| Middlebury Family Physicians, Inc | Family Medicine | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Family Medicine Physician
- Millersburg, IN
- NPI 1144368382
-
- Family Medicine Physician
- Middlebury, IN
- NPI 1366464869
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204675200000",
"number": "1104847664",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 459",
"city": "MIDDLEBURY",
"state": "IN",
"postal_code": "465400459",
"telephone_number": "574-825-2146",
"fax_number": "574-825-2182"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "206 W. WARREN STREET",
"city": "MIDDLEBURY",
"state": "IN",
"postal_code": "465400459",
"telephone_number": "574-825-2146",
"fax_number": "574-825-2182"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGGY",
"first_name": "NORMAN",
"middle_name": "S.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-21",
"last_updated": "2008-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IN",
"license": "01030282A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100361050A",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100361050B",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "R/R MEDICARE",
"identifier": "080025301",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Middlebury, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.