Stephen M Waggoner, MD

Primary specialty

Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X

License

25610 Issued in TN

Practice address

3045 Kate Bond Rd
Bartlett, TN 38133-4004

Phone

(901) 381-4664

Fax

(901) 373-3804

NPI assigned

Sep 21, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Orthopedic Surgery

Education

East Tennessee State University Quillen College of Medicine, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

MSK Group PCGroup PAC ID 4688574262, 138 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Francis Bartlett Medical Center Hospital, Bartlett, TN, CCN 440228
• Baptist Memorial Hospital Hospital, Memphis, TN, CCN 440048
• Methodist Hospitals of Memphis Hospital, Memphis, TN, CCN 440049
• St Francis Hospital Hospital, Memphis, TN, CCN 440183

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: swaggoner33670@mlh.direct-ci.com

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.

• MSK Group, PC

  dba OrthoSouth

  • Orthopaedic Surgery Physician
  • Memphis, TN
  • NPI 1376541409
  Medicare reassignment Care Compare group NPD
• MSK Group, PC

  dba OrthoSouth

  • Physical Therapist
  • Southaven, MS
  • NPI 1114793189

  Orthopaedic Surgery

  NPD
• MSK Group PC

  dba OrthoSouth

  • Orthopaedic Surgery Physician
  • Southaven, MS
  • NPI 1912303447
  NPD (past)

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

• Amisub (SFH), Inc.

  dba St. Francis Hospital

  • General Acute Care Hospital
  • Memphis, TN
  • NPI 1952326977
  Care Compare affiliation
• Baptist Memorial Hospital

  • General Acute Care Hospital
  • Memphis, TN
  • NPI 1578527172
  Care Compare affiliation
• Methodist Healthcare - Memphis Hospitals

  dba Le Bonheur Children's Hospital

  • Children's Hospital
  • Memphis, TN
  • NPI 1386709871
  Care Compare affiliation
• Methodist Healthcare - Memphis Hospitals

  • General Acute Care Hospital
  • Memphis, TN
  • NPI 1558365890
  Care Compare affiliation
• Methodist Healthcare - Memphis Hospitals

  dba Le Bonheur Children's Hospital - Germantown

  • Children's Hospital
  • Germantown, TN
  • NPI 1649654450
  Care Compare affiliation
• Saint Francis Hospital - Bartlett, Inc.

  dba St. Francis Hospital-Bartlett

  • General Acute Care Hospital
  • Bartlett, TN
  • NPI 1811929151
  Care Compare affiliation

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

{
    "created_epoch": "1127260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615161600000",
    "number": "1871589283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6077 PRIMACY PKWY STE 140",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381195742",
            "telephone_number": "901-259-1673",
            "fax_number": "901-259-7637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3045 KATE BOND RD",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381334004",
            "telephone_number": "901-381-4664",
            "fax_number": "901-373-3804"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2100 Exeter Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Germantown",
            "state": "TN",
            "postal_code": "381383966",
            "country_code": "US",
            "telephone_number": "901-641-3000",
            "fax_number": "901-373-0804",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1350 Concourse Ave Ste 363",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381042023",
            "country_code": "US",
            "telephone_number": "901-260-6161",
            "fax_number": "901-260-6162",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4515 Poplar Ave Ste 206",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381177506",
            "country_code": "US",
            "telephone_number": "901-728-6916",
            "fax_number": "901-373-3804",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAGGONER",
        "first_name": "STEPHEN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-21",
        "last_updated": "2021-03-08",
        "certification_date": "2021-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TN",
            "license": "MD0000025610",
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "TN",
            "license": "25610",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2580550",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "00760197",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DOL",
            "identifier": "0151139",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH",
            "identifier": "0547878",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSARK",
            "identifier": "96879",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1514471",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TN",
            "identifier": "4228383",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Whitney Loren Vlastos
• Walter Steven Vollmer, D.C.
• Joseph Allen Volner, D.D.S.
• Volunteers of America Mid-States (Volunteers of America of Tennessee)
• Marlon Wade
• Holly Kay Wagner
• Wal-Mart Stores East LP (Walmart Pharmacy 10-0950)
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-3599)
• Wal-Mart Stores East, LP (Vision Center 30-0950)
• Walgreen Co (Walgreens #04083)

• Orthopaedic Surgery of the Spine Physician in Bartlett, TN
• Providers in Bartlett, TN by specialty
• Orthopaedic Surgery of the Spine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2021; 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.