Active NPI
Donald Scott Waggoner, R.PH.
- Pharmacotherapy Pharmacist
- Fort Huachuca, AZ
National Provider Identifier
1780835587
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacotherapy Pharmacist
- License
- S012193
- Practice address
- 2240 Winrow Ave
USA Meddac, Rwbach
Fort Huachuca, AZ 85613 - Phone
- (520) 533-9025
- NPI assigned
- Oct 10, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacotherapy Pharmacist | 1835P1200X | S012193 | AZ | Primary |
Addresses
Primary practice location
2240 Winrow Ave
USA Meddac, Rwbach
Fort Huachuca, AZ 85613
Mailing address
2240 Winrow Ave
USA Meddac, Rwbach
Fort Huachuca, AZ 85613
Phone (520) 533-9025
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| S012193 | Other | AZ | STATE BOARD OF PHARMACY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S012193 | AZ | MD | Pharmacotherapy Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1223596800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1223596800000",
"number": "1780835587",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2240 WINROW AVE",
"address_2": "USA MEDDAC, RWBACH",
"city": "FORT HUACHUCA",
"state": "AZ",
"postal_code": "85613",
"telephone_number": "520-533-9025"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2240 WINROW AVE",
"address_2": "USA MEDDAC, RWBACH",
"city": "FORT HUACHUCA",
"state": "AZ",
"postal_code": "85613",
"telephone_number": "520-533-9025"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGGONER",
"first_name": "DONALD",
"middle_name": "SCOTT",
"name_prefix": "Mr.",
"credential": "R.PH.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-10-10",
"last_updated": "2008-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "AZ",
"license": "S012193",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE BOARD OF PHARMACY",
"identifier": "S012193",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Huachuca, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.