Active NPI
Laken Waggoner, NP
- Nurse Practitioner
- Colorado Springs, CO
National Provider Identifier
1336730977
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- C-APN.0002303-C-NP
- Practice address
- 1625 Medical Center PT Ste 100
Colorado Springs, CO 80907-5798 - Phone
- (719) 576-4744
- NPI assigned
- Jan 27, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | C-APN.0002303-C-NP | CO | Primary |
Addresses
Primary practice location
1625 Medical Center PT Ste 100
Colorado Springs, CO 80907-5798
Mailing address
1689 Smoke Ridge Dr
Colorado Springs, CO 80919-3489
Phone (812) 583-8256
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C-APN.0002303-C-NP | CO | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1611705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611705600000",
"number": "1336730977",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1689 SMOKE RIDGE DR",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809193489",
"telephone_number": "812-583-8256"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1625 MEDICAL CENTER PT STE 100",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809075798",
"telephone_number": "719-576-4744"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGGONER",
"first_name": "LAKEN",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-01-27",
"last_updated": "2021-01-27",
"certification_date": "2021-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CO",
"license": "C-APN.0002303-C-NP",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.