DR. STACEY WAGGONER (NPI# 1174146732) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174146732 |
| Entity Type | Individual |
| Full Name | DR. STACEY WAGGONER |
| Credential | EMT-A |
| Practice Address |
4 Valley Stream Ln Newnan GA 30263-2912 |
| Practice Telephone | 6783783195 |
| Mailing Telephone | 6783739865 |
| Enumeration Date | 2020-05-18 |
| Last Update Date | 2020-05-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 146M00000X | Emergency Medical Technician, Intermediate | A001035 | GA | Emergency Medical Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285008227 | Stacey Alethea Waggoner | Nurse Practitioner | 6613 N Meridian Ave, Oklahoma City, OK 73116-1423 | 2015-11-13 |
| Street Address |
4 VALLEY STREAM LN |
| City | NEWNAN |
| State | GA |
| Zip Code | 30263-2912 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114540788 | Toodocs, LLC | Personal Emergency Response Attendant | 4 Valley Stream Ln, Newnan, GA 30263-2912 | 2020-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750914115 | Tina Harvey | Counselor | 55 A, Suite A, Newnan, GA 30263 | 2020-02-13 |
| 1407492846 | Pathways Center for Behavioral & Developmental Growth | Community/Behavioral Health | 78 Hospital Road, Newnan, GA 30263 | 2019-11-20 |
| 1831672047 | Jp & Jg Enterprises | Hospice Care, Community Based | 22 Madras Parkway, Newnan, GA 30263 | 2018-09-13 |
| 1376052928 | Newnan Endoscopy Center LLC | Clinic/Center | 1200 Lower Fayetteville Rd, Newnan, GA 30263 | 2017-09-27 |
| 1417314899 | Natalie Stephens | Speech-Language Pathologist | 87 Matador Way, Newnan, GA 30263 | 2016-01-15 |
| 1376943423 | Kathryn R Fletcher | Case Manager/Care Coordinator | 30 O'tara Woods Drive, Newnan, GA 30263 | 2014-08-26 |
| 1912260068 | Tamecia Hill | Counselor | 37 2nd Ave., Newnan, GA 30263 | 2012-06-22 |
| 1013289255 | Pathways Center for Behavioral and Developmental Growth | Community/Behavioral Health | 52 Perry St, Newnan, GA 30263 | 2012-02-03 |
| 1245513092 | Rocky Mountain Holdings LLC | Ambulance | 180 W Aviation Way, Newnan, GA 30263 | 2011-09-27 |
| 1316240427 | Georgia Cvs Pharmacy, LLC | Durable Medical Equipment & Medical Supplies | 395 Jackson St, Newnan, GA 30263 | 2010-12-10 |
| Find all providers in zip 30263 | ||||
| Taxonomy Code | 146M00000X |
| Grouping | Emergency Medical Service Providers |
| Classification | Emergency Medical Technician, Intermediate |
| An Intermediate EMT is an individual trained and certified to perform intermediate life support treatment in medical emergencies based on individual state boards. |
| Notes: Sources: Tabers Medical Dictionary and Florida EMS Clearing House. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346850856 | Christopher Lee Bailey | Emergency Medical Technician, Intermediate | 1893 Lathrop St Se, Atlanta, GA 30315-6917 | 2020-08-10 |
| 1881214872 | Roger Lee Jackson II | Emergency Medical Technician, Intermediate | 713 Clifton Rd Se, Atlanta, GA 30316-2229 | 2020-04-20 |
| 1487210704 | Andre Grant | Emergency Medical Technician, Intermediate | 2136 W Park Ct Ste B, Stone Mountain, GA 30087-3528 | 2019-05-13 |
| 1760944334 | Arelious Dunn | Emergency Medical Technician, Intermediate | 6722 Highway 85 Ste 5, Riverdale, GA 30274-2373 | 2019-04-03 |
| 1811488836 | Jeffrey Touchberry | Emergency Medical Technician, Intermediate | 217 Lovebridge Dr Se, Calhoun, GA 30701-4800 | 2018-05-24 |
| 1750800058 | Shawn Anthony Moore | Emergency Medical Technician, Intermediate | 900 N Hairston Rd Ste A3, Stone Mountain, GA 30083-2857 | 2017-09-18 |
| 1689101479 | Pamela Olivia Dugar | Emergency Medical Technician, Intermediate | 3117 Deans Bridge Rd, Augusta, GA 30906-3379 | 2017-05-11 |
| 1457890824 | James Richard Dow II | Emergency Medical Technician, Intermediate | 1453 Wood Park Way Nw, Kennesaw, GA 30152-4670 | 2017-02-18 |
| 1023566387 | Kalli Pelar Coleman Addison | Emergency Medical Technician, Intermediate | 131 Cypress Ln, Eatonton, GA 31024-7567 | 2016-09-15 |
| 1437567385 | Anthony Quinn Hodge | Emergency Medical Technician, Intermediate | 4035 Jonesboro Rd Ste 240, Forest Park, GA 30297-1035 | 2014-07-23 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.