Ronald Wagoner, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

196394 Issued in AK

Practice address

10096 Kenai Spur Hwy
Kenai, AK 99611-7807

Phone

(907) 395-0871

NPI assigned

Aug 15, 2022

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

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.

• Walmart Inc.

  • Community/Retail Pharmacy
  • Kenai, AK
  • NPI 1285965772
  NPD (past)
• Walmart Inc.

  • Community/Retail Pharmacy
  • Eastvale, CA
  • NPI 1770458945
  NPD (past)

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

{
    "created_epoch": "1660521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660521600000",
    "number": "1134847379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10096 KENAI SPUR HWY",
            "city": "KENAI",
            "state": "AK",
            "postal_code": "996117807",
            "telephone_number": "907-395-0871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10096 KENAI SPUR HWY",
            "city": "KENAI",
            "state": "AK",
            "postal_code": "996117807",
            "telephone_number": "907-395-0871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGONER",
        "first_name": "RONALD",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-15",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AK",
            "license": "196394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gabriel L Vest
• Natalie Villegas
• Rodolfo Luis Villegas Jr.
• Michael K Visick, MD
• Amanda Waggoner
• Christy Lynn Walker
• Jared Lee Wallace, PA-C
• Walmart Inc.
• Craig Timothy Ward, M.A.
• Curtis Judson Warren, PT, DPT.

• Pharmacist in Kenai, AK
• Providers in Kenai, AK by specialty
• Pharmacist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.