Waggoner Chiropractic Health Center, LLC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

2257 Issued in CO

Legal business name

WAGGONER CHIROPRACTIC HEALTH CENTER, LLC

Practice address

824 E Fillmore St
Colorado Springs, CO 80907-6375

Phone

(719) 634-2579

Fax

(719) 634-2371

NPI assigned

May 13, 2014

Organization subpart

No

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

Authorized official

Name

Clinton C Waggoner, D.C.

Title

Chiropractor

Phone

(719) 634-2579

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Clinton C Waggoner CH

  • Orthopedic Chiropractor
  • Colorado Springs, CO
  • NPI 1184762064
  Medicare reassignment NPD

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

{
    "created_epoch": "1399939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399939200000",
    "number": "1225449283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "824 E FILLMORE ST",
            "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 E FILLMORE ST",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809076375",
            "telephone_number": "719-634-2579",
            "fax_number": "719-634-2371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAGGONER CHIROPRACTIC HEALTH CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-13",
        "last_updated": "2014-05-13",
        "status": "A",
        "authorized_official_last_name": "WAGGONER",
        "authorized_official_first_name": "CLINTON",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "719-634-2579",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "CO",
            "license": "2257",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "C27393",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diedre A Wagers, M.D.
• Chelsea Wages, MFTC
• Jennifer Jean Wages, ATC, OTC
• Skyler Wages
• Clinton C Waggoner CH
• Addison Jade Waggoner
• Garrett Waggoner, RBT
• Laken Waggoner, NP
• Lindsey Waggoner, MA, LPCC
• F William Wagle II, DDS

• Health Service Clinic/Center in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Health Service Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.