Active NPI
Steven Edward Waggoner, DC
- Chiropractor
- Demorest, GA
National Provider Identifier
1942334271
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 007483
- Practice address
- 101 Demorest Square Dr
Suite G
Demorest, GA 30535-6044 - Phone
- (706) 776-7852
- Fax
- (706) 776-0011
- NPI assigned
- Mar 16, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 007483 | GA | Primary |
Addresses
Primary practice location
101 Demorest Square Dr
Suite G
Demorest, GA 30535-6044
Mailing address
101 Demorest Square Dr
Suite G
Demorest, GA 30535-6044
Phone (706) 776-7852
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 007483 | GA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1298937600000",
"number": "1942334271",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 DEMOREST SQUARE DR",
"address_2": "SUITE G",
"city": "DEMOREST",
"state": "GA",
"postal_code": "305356044",
"telephone_number": "706-776-7852",
"fax_number": "706-776-0011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 DEMOREST SQUARE DR",
"address_2": "SUITE G",
"city": "DEMOREST",
"state": "GA",
"postal_code": "305356044",
"telephone_number": "706-776-7852",
"fax_number": "706-776-0011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGGONER",
"first_name": "STEVEN",
"middle_name": "EDWARD",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-16",
"last_updated": "2011-03-01",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "GA",
"license": "007483",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Demorest, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.