Keith Waggoner, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

18247 Issued in WV

Practice address

1824 Murdoch Ave
Parkersburg, WV 26101-3230

Phone

(304) 424-4111

Fax

(330) 656-5901

NPI assigned

Dec 22, 2005

Last updated

Jun 12, 2008By the provider in NPPES

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

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Emergency Medicine

Education

University of Mississippi School of Medicine, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University Emergency Specialists LLCGroup PAC ID 4587807854, 14 clinicians

Ues Geneva LLCGroup PAC ID 4789827064, 14 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Uhhs Memorial Hospital of Geneva Hospital, Geneva, OH, CCN 361307
• University Hospitals Conneaut Medical Center Hospital, Conneaut, OH, CCN 361308

Merit-based Incentive Payment System (MIPS)

Final score

96.46 of 100Reported as group

Quality

90.17

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kwaggoner37873@ehrdirect.uhhospitals.org

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.

• Ues Geneva LLC

  • Emergency Medicine Physician
  • Geneva, OH
  • NPI 1689919029
  Medicare reassignment Care Compare group NPD
• University Emergency Specialists LLC

  • Emergency Medicine Physician
  • Conneaut, OH
  • NPI 1033454483
  Medicare reassignment Care Compare group NPD
• Magis Emergency Medicine LLC

  • Emergency Medicine Physician
  • Parma, OH
  • NPI 1801287511
  Medicare reassignment NPD
• Physicians Link Center LLC

  • Emergency Medicine Physician
  • Elyria, OH
  • NPI 1235172925
  Medicare reassignment NPD
• Ues Ahuja LLC

  • Emergency Medicine Physician
  • Beachwood, OH
  • NPI 1467883934
  Medicare reassignment NPD
• Ues Geauga, LLC

  • Emergency Medicine Physician
  • Chardon, OH
  • NPI 1841242997
  Medicare reassignment NPD
• 4M Emergency Systems of Parkersburg, Inc

  • Emergency Medicine Physician
  • Parkersburg, WV
  • NPI 1295787349
  NPD (past)
• 4M Emergency Systems of West Virginia

  • Emergency Medicine Physician
  • Parkersburg, WV
  • NPI 1972715837
  NPD (past)
• Community Health Association

  dba JGH Therapy and SportsCare

  • Physical Therapy Clinic/Center
  • Ravenswood, WV
  • NPI 1124369780
  NPD (past)
• Emergency Services of Central Ohio LLC

  • Emergency Medicine Physician
  • Barberton, OH
  • NPI 1427322726
  NPD (past)
• Memorial Hospital of Geneva

  • Emergency Medicine Physician
  • Geneva, OH
  • NPI 1164519831
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• University Hospitals Conneaut Medical Center

  • Critical Access Hospital
  • Conneaut, OH
  • NPI 1902996119
  Care Compare affiliation
• University Hospitals Geneva Medical Center

  • Critical Access Hospital
  • Geneva, OH
  • NPI 1225128432
  Care Compare affiliation

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213228800000",
    "number": "1225015050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 DARROW RD",
            "address_2": "SUITE 106",
            "city": "HUDSON",
            "state": "OH",
            "postal_code": "442365021",
            "telephone_number": "330-656-5911",
            "fax_number": "330-656-5901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1824 MURDOCH AVE",
            "city": "PARKERSBURG",
            "state": "WV",
            "postal_code": "261013230",
            "telephone_number": "304-424-4111",
            "fax_number": "330-656-5901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGGONER",
        "first_name": "KEITH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2008-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WV",
            "license": "18247",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WV DWC",
            "identifier": "1060095",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "000428862",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0168152",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0046291000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ryan Wachter
• Alicia Wade
• Brittany A Wade
• Jessica Waggoner
• Jolina Waggoner
• Melina Waggoner
• Myla Waggoner
• Tammy Waggoner
• Dean S Wagner, CRNA
• Emily Wagner, LPC

• Emergency Medicine Physician in Parkersburg, WV
• Providers in Parkersburg, WV by specialty
• Emergency Medicine Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.