Active NPI
Scott A Waggoner, CRNA
- Certified Registered Nurse Anesthetist
- Dallas, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 1138853
- Practice address
- 12222 Merit Dr Ste 600
Dallas, TX 75251-3294 - Phone
- (972) 715-5000
- Fax
- (972) 715-9976
- NPI assigned
- Nov 11, 2014
- Last updated
- May 6, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 041.425396 | IL | |
| Certified Registered Nurse Anesthetist | 367500000X | 209.012327 | IL | |
| Certified Registered Nurse Anesthetist | 367500000X | 1138853 | TX | Primary |
Addresses
Primary practice location
12222 Merit Dr Ste 600
Dallas, TX 75251-3294
Mailing address
2202 Harlem Rd
Loves Park, IL 61111-2754
Phone (815) 877-4848
Other practice location 1
2202 Harlem Rd
Loves Park, IL 61111-2754
Phone (815) 877-4848
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL, TX
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1201 W 38TH St
Austin, TX 78705-1006
Phone (512) 324-1000
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 88.94 of 100
- Quality
- 91.31
- Improvement activities
- 40
- Cost
- 79.05
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041.425396 | IL | MD | Registered Nurse |
| 209.012327 | IL | MD | Certified Registered Nurse Anesthetist |
| 1138853 | TX | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| U S Anesthesia Partners of Texas, PA | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| U. S. Anesthesia Partners of Texas, P.a., | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Rockford Anesthesiologists Associated, L.L.C. | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Rockford Anesthesiologists Associated, L.L.C. | Current | Accepting new patients | |
| Northstar Anesthesia of Illinois, LLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
Locations
2202 Harlem Rd
Loves Park, IL 61111
Phone (815) 877-4848
2202 Harlem Rd
#200
Loves Park, IL 61111
Phone (815) 877-4848
20201 Crawford Ave
Olympia Flds, IL 60461
Phone (708) 503-3857
1016 Featherstone Rd
Rockford, IL 61107
Phone (815) 226-3300
1401 E State St
Rockford, IL 61104
Phone (815) 489-4267
1423 Chicago Rd
Sauk Village, IL 60411
Phone (708) 679-2160
1201 W 38th St
Austin, TX 78705
Phone (512) 324-1058
4900 Mueller Blvd
Austin, TX 78723
Phone (512) 324-0165
12222 Merit Dr
Ste 600
Dallas, TX 75251
Phone (972) 776-3185
100 Medical Dr
Lake Jackson, TX 77566
Phone (713) 496-7555
9250 Pinecroft Dr
Shenandoah, TX 77380
Phone (281) 364-2300
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.
-
dba Greater Houston Anesthesiology, P.A.
- Anesthesiology Physician
- Houston, TX
- NPI 1548208564
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Arlington, TX
- NPI 1962822395
IL, Nurse Anesthetist, Certified Registered
-
- Certified Registered Nurse Anesthetist
- Loves Park, IL
- NPI 1629090642
Nurse Anesthetist, Certified Registered
-
- Interventional Pain Medicine Physician
- Addison, TX
- NPI 1053800391
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Loves Park, IL
- NPI 1639128598
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Ascension Seton Williamson
- General Acute Care Hospital
- Round Rock, TX
- NPI 1578780870
-
dba Ascension Seton Cedar Park
- General Acute Care Hospital
- Cedar Park, TX
- NPI 1376662296
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1415664000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714953600000",
"number": "1336545854",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2202 HARLEM RD",
"city": "LOVES PARK",
"state": "IL",
"postal_code": "611112754",
"telephone_number": "815-877-4848",
"fax_number": "815-636-6125"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12222 MERIT DR STE 600",
"city": "DALLAS",
"state": "TX",
"postal_code": "752513294",
"telephone_number": "972-715-5000",
"fax_number": "972-715-9976"
}
],
"practiceLocations": [
{
"address_1": "2202 Harlem Rd",
"address_purpose": "LOCATION",
"city": "Loves Park",
"state": "IL",
"postal_code": "611112754",
"country_code": "US",
"telephone_number": "815-877-4848",
"fax_number": "815-636-6125",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WAGGONER",
"first_name": "SCOTT",
"middle_name": "A",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-11-11",
"last_updated": "2024-05-06",
"certification_date": "2024-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "IL",
"license": "041.425396",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "IL",
"license": "209.012327",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "TX",
"license": "1138853",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.