Stacey Waggoner, EMT-A

Primary specialty

Intermediate Emergency Medical TechnicianTaxonomy code 146M00000X

License

A001035 Issued in GA

Practice address

4 Valley Stream LN
Newnan, GA 30263-2912

Phone

(678) 378-3195

NPI assigned

May 18, 2020

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Toodocs, LLC

  dba Coweta's Sweet Water Pool Services

  • Personal Emergency Response Attendant
  • Newnan, GA
  • NPI 1114540788
  NPD Authorized official

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

{
    "created_epoch": "1589760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589760000000",
    "number": "1174146732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 VALLEY STREAM LN",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302632912",
            "telephone_number": "678-373-9865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 VALLEY STREAM LN",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302632912",
            "telephone_number": "678-378-3195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGGONER",
        "first_name": "STACEY",
        "name_prefix": "Dr.",
        "credential": "EMT-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-18",
        "last_updated": "2020-05-18",
        "certification_date": "2020-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146M00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Intermediate",
            "state": "GA",
            "license": "A001035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vital Care Transports Inc (Coweta Co EMS)
• Kent Alan Voyce, OD
• VSM Aberdeen Dental LLC (Aberdeen Dental)
• Margaret C Wade, RPH
• Ashley King Wafford, PA
• Kurt Louis Wahnschaff
• Mary Catherine Waite
• Nicole Elizabeth Waitt, M.ED., BCBA
• Wal-Mart Stores East LP (Walmart Pharmacy 10-0494)
• Wal-Mart Stores East, LP (Vision Center 30-0494)

• Intermediate Emergency Medical Technician in Newnan, GA
• Providers in Newnan, GA by specialty
• Intermediate Emergency Medical Technician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2020; 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.