Chad Michael Waggoner, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

ODTG00743 Issued in RI

Practice address

891 Westminster St
Providence, RI 02903-4020

Phone

(401) 331-7850

Fax

(401) 274-4739

NPI assigned

May 17, 2006

Last updated

Jun 27, 2023By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in UT, CO2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Optometry

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Neil W McAllister OD PCGroup PAC ID 4688627607, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Neil W McAllister OD PC

  dba Powers Eye Center

  • Optometrist
  • Colorado Springs, CO
  • NPI 1083731020
  Medicare reassignment Care Compare group NPD
• Powers Eye Center PLLC

  • Optometrist
  • Colorado Springs, CO
  • NPI 1003767518
  Medicare reassignment NPD Authorized official
• Sharon Richens MD Eye Physician & Surgeon PC

  dba Richens Eye Center

  • Ophthalmology Physician
  • St George, UT
  • NPI 1891892063
  Medicare reassignment NPD

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1285686139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2915 BENJAMIN CT SE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985014807",
            "telephone_number": "360-754-2817",
            "fax_number": "360-456-3894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "891 WESTMINSTER ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034020",
            "telephone_number": "401-331-7850",
            "fax_number": "401-274-4739"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "161 W 200 N Ste 200",
            "address_purpose": "LOCATION",
            "city": "Saint George",
            "state": "UT",
            "postal_code": "847707386",
            "country_code": "US",
            "telephone_number": "435-652-4040",
            "fax_number": "435-652-1516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAGGONER",
        "first_name": "CHAD",
        "middle_name": "MICHAEL",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00003598",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "RI",
            "license": "ODTG00743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lynn Anne Wachtel, RNP
• Marion Lynn Wachtenheim, M.S.W.
• Heather Waddell, PT
• Neha Wadhavkar, MD
• Kenneth Judson Wagg, RPH
• Laurie Wagner-Abreu
• Peter J Wagner, M.D.
• Richard Laverne Wagner, MD
• Stephanie Bing Wagner, MD/MPH
• Ayman M. Wahbeh, M.D.

• Optometrist in Providence, RI
• Providers in Providence, RI by specialty
• Optometrist in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2023; 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.