Taylor Lauren Waggoner, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2078DT Issued in KY

Practice address

1020 Gibson Bay Dr
Richmond, KY 40475-3448

Phone

(859) 623-3358

Fax

(859) 623-8141

NPI assigned

Nov 28, 2017

Last updated

Nov 28, 2017By 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 KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Indiana University - School of Optometry, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dr. Gary E. King Optometrist PSCGroup PAC ID 8628138229, 5 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Dr. Gary E. King Optometrist PSC

  • Clinic/Center
  • Berea, KY
  • NPI 1588819080
  Medicare reassignment Care Compare group NPD
• Eyecare Center Optometrist PSC

  • Optometrist
  • Richmond, KY
  • NPI 1851384960
  Medicare reassignment NPD

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

{
    "created_epoch": "1511827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511827200000",
    "number": "1447764535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 GIBSON BAY DR",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "404753448",
            "telephone_number": "859-623-3358",
            "fax_number": "859-623-8141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 GIBSON BAY DR",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "404753448",
            "telephone_number": "859-623-3358",
            "fax_number": "859-623-8141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGGONER",
        "first_name": "TAYLOR",
        "middle_name": "LAUREN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-28",
        "last_updated": "2017-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "2078DT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yehor Vitel, DPT
• Peter Thomas Vogel, PT
• Ellen Ward Vogt, DPT
• Phyllis Diana Voynar, P.T.
• Hannah Renee Wade, PT, DPT
• Brandon S Wait
• Wal-Mart Stores East LP (Walmart Pharmacy 10-0719)
• Wal-Mart Stores East, LP (Vision Center 30-0719)
• Walgreen Co (Walgreens #19411)
• Walgreen Co (Rite Aid #18161)

• Optometrist in Richmond, KY
• Providers in Richmond, KY by specialty
• Optometrist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2017; 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.