Melissa Waggener, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

43590 Issued in OK

Practice address

1500 S Main St
Fort Worth, TX 76104-4941

Phone

(817) 702-1100

NPI assigned

Nov 17, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1605571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772755200000",
    "number": "1497358014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 S MAIN ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044941",
            "telephone_number": "817-702-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 S MAIN ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044941",
            "telephone_number": "817-702-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGGENER",
        "first_name": "MELISSA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-17",
        "last_updated": "2026-03-06",
        "certification_date": "2026-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OK",
            "license": "43590",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "805977",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Y Wade, LCSW
• Terri Losack Wade, FNP
• Artelia Wadley, D.C.
• Kaitlyn Wages
• James L Waggener, DO
• Nathan Waggoner
• Charlyn Pafford Wagley
• Kristin Wagman
• Paul Andrew Wagman
• Alison Wagner

• Surgery Physician in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.