Clinton C Waggoner CH

Primary specialty

Orthopedic ChiropractorTaxonomy code 111NX0800X

License

2257 Issued in CO

Practice address

824 East Fillmore Steet
Colorado Springs, CO 80907-6375

Phone

(719) 634-2579

Fax

(719) 634-2371

NPI assigned

Feb 2, 2007

Sex

Male

Sole proprietor

Yes

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

Enrolled in CO

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - West Sunnyvale, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Waggoner Chiropractic Health Center, LLC

  • Health Service Clinic/Center
  • Colorado Springs, CO
  • NPI 1225449283
  Medicare reassignment NPD

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214438400000",
    "number": "1184762064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "824 EAST FILLMORE STEET",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809076375",
            "telephone_number": "719-634-2579",
            "fax_number": "719-634-2371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "824 EAST FILLMORE STEET",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809076375",
            "telephone_number": "719-634-2579",
            "fax_number": "719-634-2371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGGONER CH",
        "first_name": "CLINTON",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-02",
        "last_updated": "2008-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NX0800X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Orthopedic",
            "state": "CO",
            "license": "2257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erika Nicole Wager
• Diedre A Wagers, M.D.
• Chelsea Wages, MFTC
• Jennifer Jean Wages, ATC, OTC
• Skyler Wages
• Waggoner Chiropractic Health Center, LLC
• Addison Jade Waggoner
• Garrett Waggoner, RBT
• Laken Waggoner, NP
• Lindsey Waggoner, MA, LPCC

• Orthopedic Chiropractor in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Orthopedic Chiropractor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.