NPIMap

Individual provider Active NPI

Christopher Joseph Waguespack, D.O.

  • Family Medicine Physician
  • Pike Road, AL
National Provider Identifier
1275775165
Registry record updated Feb 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO1346 Issued in AL
Practice address
11123 Chantilly Pkwy CT
Suite M
Pike Road, AL 36064-2880
Phone
(334) 832-2301
NPI assigned
Mar 24, 2009
Last updated
Feb 18, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036.122210 IL
Family Medicine Physician 207Q00000X 0102202301 VA
Family Medicine Physician 207Q00000X DO1346 AL Primary

Addresses

Primary practice location

11123 Chantilly Pkwy CT
Suite M
Pike Road, AL 36064-2880

Mailing address

11123 Chantilly Pkwy CT
Suite M
Pike Road, AL 36064-2880
Phone (334) 832-2301

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131120002075 AL Practitioner - Family PracticePractitioner - Internal Medicine 2365683166 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Lake Erie College of Osteopathic Medicine, Erie, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jackson Hospital and Clinic, IncGroup PAC ID 0547254153, 119 clinicians

Practice addresses (Care Compare)

1722 Pine St
Montgomery, AL 36106-1160

1801 Pine St
Montgomery, AL 36106-1154

9521 Vaughn Rd
Pike Road, AL 36064-2292
Phone (334) 523-6047

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.26 of 100Reported as individual
Quality
64.77
Promoting interoperability
100
Improvement activities
40
Cost
76.11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
DO1346ALMDFamily Medicine Physician
036.122210ILMDFamily Medicine Physician
0102202301VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson Hospital and Clinic Inc. Family Medicine CurrentSince Sep 1, 2013 Accepting new patients
Jackson Hospital and Clinic, Inc. Family Medicine Current Accepting new patients
Jackson Hospital & Clinic, Inc. CurrentSince Sep 1, 2013 Accepting new patients
Jackson Hospital & Clinic, Inc. Past Accepting new patients
Jackson Hospital and Clinic, Inc Family Medicine Past Accepting new patients

Locations

1722 Pine St
Ste 203
Montgomery, AL 36106
Phone (334) 271-1263

1722 Pine St
Ste 503
Montgomery, AL 36106
Phone (334) 240-2337

1725 Pine St
Montgomery, AL 36106
Phone (334) 293-8000

1801 Pine St
Ste 103
Montgomery, AL 36106
Phone (334) 293-8888

11123 Chantilly Pkwy Ct
Unit M
Pike Road, AL 36064
Phone (334) 293-8888

Interoperability endpoints

  • Direct secure messaging: christopher.waguespack.1@9186.direct.athenahealth.com

Organizations & group practices 5

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1237852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392681600000",
    "number": "1275775165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11123 CHANTILLY PKWY CT",
            "address_2": "SUITE M",
            "city": "PIKE ROAD",
            "state": "AL",
            "postal_code": "360642880",
            "telephone_number": "334-832-2301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11123 CHANTILLY PKWY CT",
            "address_2": "SUITE M",
            "city": "PIKE ROAD",
            "state": "AL",
            "postal_code": "360642880",
            "telephone_number": "334-832-2301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGUESPACK",
        "first_name": "CHRISTOPHER",
        "middle_name": "JOSEPH",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-24",
        "last_updated": "2014-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036.122210",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0102202301",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "DO1346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pike Road, AL

Sources for this page

Verify at the official NPI Registry.