Kristina Waggoner, NP-C

Primary specialty

Gerontology Clinical Nurse SpecialistTaxonomy code 364SG0600X

License

AG0315147 Issued in GA

Practice address

2122 Manchester Expy
Columbus, GA 31904-6878

Phone

(706) 596-4000

NPI assigned

Mar 27, 2015

Sex

Female

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 GA

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 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kristina.waggoner.p1@direct.chhokarclinic.nextgenshare.com

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.

• Inphynet Primary Care Physicians Southeast PC

  • Emergency Medicine Physician
  • Columbus, GA
  • NPI 1770521460
  Medicare reassignment NPD

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

{
    "created_epoch": "1427414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642723200000",
    "number": "1225422231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 MANCHESTER EXPY",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319046878",
            "telephone_number": "706-596-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2122 MANCHESTER EXPY",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319046878",
            "telephone_number": "706-596-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGGONER",
        "first_name": "KRISTINA",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-27",
        "last_updated": "2022-01-21",
        "certification_date": "2022-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SG0600X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Gerontology",
            "state": "GA",
            "license": "AG0315147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brinkley Wade, CFY-SLP
• Cynthia Wade, LCSW
• Thomas A. Wade Jr., MD
• Janvi Hemantkumar Wadiwala, MD
• Kathleen Moore Wadsworth, NP-C
• Dionna Wainwright
• Taneshia Laquette Wakefield
• Wal-Mart Stores East LP
• Wal-Mart Stores East LP
• Wal-Mart Stores East LP

• Gerontology Clinical Nurse Specialist in Columbus, GA
• Providers in Columbus, GA by specialty
• Gerontology Clinical Nurse Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.