Rex D Waggoner PA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

C00272 Issued in AR

Legal business name

REX D WAGGONER PA

Practice address

609 W Maple Ave
Springdale, AR 72764-5335

Phone

(479) 751-5711

NPI assigned

Apr 16, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Rex D Waggoner, CRNANPI 1790769164

Title

President

Phone

(479) 751-6352

Specialties & licenses 1

Addresses

Practitioners 1

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

• Rex Dwayne Waggoner, CRNA

  • Certified Registered Nurse Anesthetist
  • Springdale, AR
  • NPI 1790769164

  Nurse Anesthetist, Certified Registered

  NPD (past) Authorized official

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1285859009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 580",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727650580",
            "telephone_number": "479-751-6352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 W MAPLE AVE",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727645335",
            "telephone_number": "479-751-5711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REX D WAGGONER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WAGGONER",
        "authorized_official_first_name": "REX",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "479-751-6352",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "C00272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Gregory Reiter, DO
• Avin D Rekhi, M.D.
• Stanley Michael Rest, PHD
• Retina Partners of Northwest Arkansas PLLC
• Grace Anna Rew, LAC
• Doliza Reyes-Bibbs, LCSW
• Abel Reyes
• Ashley M Reynolds
• Kayla Marie Reynolds, APRN
• Laura Beth Reynolds, RN

• Certified Registered Nurse Anesthetist in Springdale, AR
• Providers in Springdale, AR by specialty
• Certified Registered Nurse Anesthetist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.