Individual provider Active NPI

Maggie Waggoner

  • Physician Assistant
  • South Point, OH
National Provider Identifier
1154047231
Registry record updated Feb 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
335 Township Road 1026
South Point, OH 45680-7842
Phone
(740) 744-4055
NPI assigned
Oct 19, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

335 Township Road 1026
South Point, OH 45680-7842

Mailing address

PO Box 390
Huntington, WV 25708-0390
Phone (304) 429-1088

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, OH3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20231019002470 FL Practitioner - Physician Assistant 6305292848 Reassigns benefits to 2 organizations
I20250321001303 OH Practitioner - Physician Assistant 6305292848 Reassigns benefits to 1 organization
I20250625003831 OH Practitioner - Mental Health Counselor 6305292848 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ohio Valley Physicians Inc CurrentSince Feb 10, 2025 Accepting new patients
Ohio Valley Physicians Inc Past Accepting new patients
Ohio Valley Physicians Inc Past Accepting new patients

Locations

936 State Route 160
Gallipolis, OH 45631
Phone (740) 446-4600

335 Township Road 1026
South Point, OH 45680
Phone (740) 744-4055

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1666137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739404800000",
    "number": "1154047231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 390",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257080390",
            "telephone_number": "304-429-1088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 TOWNSHIP ROAD 1026",
            "city": "SOUTH POINT",
            "state": "OH",
            "postal_code": "456807842",
            "telephone_number": "740-744-4055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGGONER",
        "first_name": "MAGGIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-19",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Point, OH

Sources for this page

Verify at the official NPI Registry.