NPIMap

Individual provider Active NPI

Julian Richard Waggoner III, M.D.

  • Anesthesiology Physician
  • Albert Lea, MN
National Provider Identifier
1447239645
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
37261 Issued in MN
Practice address
404 W Fountain St
Albert Lea, MN 56007-2437
Phone
(507) 373-2384
NPI assigned
Jan 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 37261 MN Primary

Addresses

Primary practice location

404 W Fountain St
Albert Lea, MN 56007-2437

Mailing address

21301 Indian Hills Rd
Albert Lea, MN 56007-4222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100211000490 MN Practitioner - AnesthesiologyPractitioner - Emergency Medicine 4284777343 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Alabama School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Josephs Medical CenterGroup PAC ID 8224948443, 238 clinicians

Practice addresses (Care Compare)

523 N 3Rd St
Brainerd, MN 56401-3054
Phone (218) 828-7394

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph'S Medical Center Current Accepting new patients
Allina Health System Current Accepting new patients
St Joseph'S Medical Center CurrentSince Sep 23, 2024 Accepting new patients
St. Joseph'S Medical Center CurrentSince Sep 23, 2024 Accepting new patients
Metropolitan Anesthesia Network, LLP Anesthesiology CurrentSince Feb 3, 2020 Accepting new patients
Allina Health System CurrentSince Jan 4, 2016 Accepting new patients
Allina Health System CurrentSince Jan 4, 2016 Accepting new patients
James R. Nunley D.O., P.C. Past Accepting new patients

Locations

601 W Chandler St
Arlington, MN 55307
Phone (507) 964-2271

523 N 3rd St
Brainerd, MN 56401
Phone (218) 828-7394

701 Dellwood St S
Cambridge, MN 55008
Phone (763) 689-7700

13601 80th Cir N
Ste 100
Maple Grove, MN 55369
Phone (612) 219-5355

4050 Coon Rapids Blvd NW
Minneapolis, MN 55433
Phone (763) 236-6786

800 E 28th St
Minneapolis, MN 55407
Phone (612) 863-3547

8100 W 78th St
Ste 220
Minneapolis, MN 55439
Phone (952) 914-8400

Organizations & group practices 8

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.

Hospital & facility affiliations 10

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

NPI Registry JSON

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

{
    "created_epoch": "1137369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1447239645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21301 INDIAN HILLS RD",
            "city": "ALBERT LEA",
            "state": "MN",
            "postal_code": "560074222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 W FOUNTAIN ST",
            "city": "ALBERT LEA",
            "state": "MN",
            "postal_code": "560072437",
            "telephone_number": "507-373-2384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGGONER",
        "first_name": "JULIAN",
        "middle_name": "RICHARD",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-16",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MN",
            "license": "37261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albert Lea, MN

Sources for this page

Verify at the official NPI Registry.