Christian Oneal Waggoner, YPSS CERTIFED

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

1620 Kentucky Ave
Paducah, KY 42003-2851

Phone

(270) 442-7121

Fax

(270) 443-9692

NPI assigned

Jul 31, 2019

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1564531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564531200000",
    "number": "1477107126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 BROADWAY ST STE 201",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420010713",
            "telephone_number": "270-442-7121",
            "fax_number": "270-443-9692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 KENTUCKY AVE",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420032851",
            "telephone_number": "270-442-7121",
            "fax_number": "270-443-9692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGGONER",
        "first_name": "CHRISTIAN",
        "middle_name": "ONEAL",
        "credential": "YPSS CERTIFED",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-31",
        "last_updated": "2019-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Madison Kate Wagner
• Allie R Wagoner
• Wal-Mart Stores East LP (Walmart Pharmacy 10-0431)

• Counselor in Paducah, KY
• Providers in Paducah, KY by specialty
• Counselor in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.