Active NPI
Heather Lynne Waggoner, LISWS
- Social Worker
- Dayton, OH
National Provider Identifier
1386815207
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- I0007672S
- Practice address
- 600 Wayne Avenue
Dayton, OH 45410 - Phone
- (937) 496-2000
- Fax
- (937) 463-2901
- NPI assigned
- Mar 19, 2008
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | I0007672S | OH | Primary |
Addresses
Primary practice location
600 Wayne Avenue
Dayton, OH 45410
Mailing address
600 Wayne Avenue
Dayton, OH 45410
Phone (937) 496-2000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0000003211683 | Other | OH | ANTHEM BCBS |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| I0007672S | OH | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Samaritan Behavioral Health, Inc. | Past | Accepting new patients | |
| Nova Behavioral Health, Inc. | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Substance Abuse Rehabilitation Facility
- Dayton, OH
- NPI 1164782017
-
- Community/Behavioral Health Agency
- Dayton, OH
- NPI 1235490939
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205884800000",
"number": "1386815207",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 WAYNE AVENUE",
"city": "DAYTON",
"state": "OH",
"postal_code": "45410",
"telephone_number": "937-496-2000",
"fax_number": "937-463-2901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 WAYNE AVENUE",
"city": "DAYTON",
"state": "OH",
"postal_code": "45410",
"telephone_number": "937-496-2000",
"fax_number": "937-463-2901"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGGONER",
"first_name": "HEATHER",
"middle_name": "LYNNE",
"name_prefix": "Ms.",
"credential": "LISWS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-03-19",
"last_updated": "2008-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OH",
"license": "I0007672S",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS",
"identifier": "0000003211683",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dayton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.