Gwendolyn Field Wagoner, M.D.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

2007-00840 Issued in NC

Practice address

110 Charlois Blvd
Winston Salem, NC 27103-1522

Phone

(336) 768-3361

NPI assigned

May 23, 2007

Last updated

May 31, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Otolaryngology

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Charlotte Eye Ear Nose and Throat Associates PAGroup PAC ID 0446155451, shared by 3 NPIs, 181 clinicians

Piedmont Ear, Nose and Throat Associates, P.a.Group PAC ID 4486617032, 28 clinicians

Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Novant Health Forsyth Medical Center Hospital, Winston-Salem, NC, CCN 340014

Merit-based Incentive Payment System (MIPS)

Final score

74.6 of 100Reported as group

Quality

31.13

Promoting interoperability

99

Improvement activities

40

Cost

85.04

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gwendolynwagoner@penta.allscriptsdirect.net

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.

• Piedmont Ear, Nose & Throat Associates, P.a.

  dba Piedmont Ear, Nose, and Throat

  • Otolaryngology Physician
  • Winston Salem, NC
  • NPI 1649216631
  Medicare reassignment Care Compare group NPD
• Charlotte Eye Ear Nose & Throat Associates, P.a.

  • Otolaryngology Physician
  • Winston Salem, NC
  • NPI 1710814405
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Forsyth Memorial Hospital, Inc.

  dba Novant Health Forsyth Medical Center

  • General Acute Care Hospital
  • Winston Salem, NC
  • NPI 1447200233
  Care Compare affiliation

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559260800000",
    "number": "1396955589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 CHARLOIS BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031522",
            "telephone_number": "336-768-3361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 CHARLOIS BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031522",
            "telephone_number": "336-768-3361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGONER",
        "first_name": "GWENDOLYN",
        "middle_name": "FIELD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-23",
        "last_updated": "2019-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NC",
            "license": "2007-00840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Anne Waggener, MD
• Jennifer Cherry Waggoner, CRNA
• Stephen James Waggoner, PT
• Kim A Wagner-Evans, MS, LPC-A, LCAS-A
• April Diane Wagner
• Jennifer Kay Wagstaff
• Ali Saeed Wahla, M.D
• George Sidney Waits IV, M.D.
• Wake Air Care LLC
• Wake Forest Ambulatory Ventures, LLC

• Otolaryngology Physician in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Otolaryngology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2019; 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.