Individual provider Active NPI

Gretchen Lynnette Waggoner, AU.D.

  • Audiologist
  • Columbus, OH
National Provider Identifier
1194837534
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
A01097 Issued in OH
Practice address
456 W 10TH Ave
4A
Columbus, OH 43210-1240
Phone
(614) 293-8065
Fax
(614) 293-6179
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X A01097 OH Primary

Addresses

Primary practice location

456 W 10TH Ave
4A
Columbus, OH 43210-1240

Mailing address

14987 State Rd
Ostrander, OH 43061-9508
Phone (740) 666-0004

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070221000384 OH Practitioner - Qualified Audiologist 1658473616 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Union County Physician CorporationGroup PAC ID 1557419173, 105 clinicians

Practice addresses (Care Compare)

1958 E US Hwy 36
Urbana, OH 43078-9799
Phone (937) 578-2417

Merit-based Incentive Payment System (MIPS)

Final score
83.33 of 100Reported as group
Quality
68.93
Promoting interoperability
100
Improvement activities
40
Cost
75.49

Merit-based Incentive Payment System (MIPS)

Final score
46.9 of 100Reported as group
Quality
0
Promoting interoperability
99
Improvement activities
0
Cost
73.84

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A01097OHMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Union County Physician Corporation CurrentSince Jan 29, 2024 Accepting new patients
Union County Physician Corporation CurrentSince Jan 29, 2024 Accepting new patients

Locations

140 Colemans Crossing Blvd
Ste 200
Marysville, OH 43040
Phone (937) 578-2207

388 Damascus Rd
Marysville, OH 43040
Phone (937) 578-2626

1958 E US Highway 36
Ste D
Urbana, OH 43078
Phone (937) 578-2626

1958 E US Highway 36
Urbana, OH 43078
Phone (937) 652-1834

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.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194837534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14987 STATE RD",
            "city": "OSTRANDER",
            "state": "OH",
            "postal_code": "430619508",
            "telephone_number": "740-666-0004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "456 W 10TH AVE",
            "address_2": "4A",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101240",
            "telephone_number": "614-293-8065",
            "fax_number": "614-293-6179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGGONER",
        "first_name": "GRETCHEN",
        "middle_name": "LYNNETTE",
        "name_prefix": "Mrs.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "OH",
            "license": "A01097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.