MICHAEL WAGGONER OD PA (NPI# 1992021190) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992021190 |
| Entity Type | Organization |
| Organization Name | MICHAEL WAGGONER OD PA |
| Practice Address |
2630 E Citizens Dr Ste 6 Fayetteville AR 72703-4797 |
| Practice Telephone | 4795821212 |
| Practice Fax Number | 4795822070 |
| Mailing Telephone | 4795821212 |
| Mailing Fax Number | 4795822070 |
| Enumeration Date | 2010-04-13 |
| Last Update Date | 2015-08-12 |
| Authorized Official Name | MICHAEL WAGGONER (OWNER) |
| Authorized Official Telephone | 4795821212 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 302R00000X | Health Maintenance Organization | 2411 | AR | Managed Care Organizations |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | NPI | 1639185341 | 01 |
| AR | MEDICARE GROUP PTAN | 5G500 | 01 |
| AR | 127297722 | 05 | |
| AR | GROUP NPI | 1992021190 | 01 |
| Street Address |
2630 E CITIZENS DR STE 6 |
| City | FAYETTEVILLE |
| State | AR |
| Zip Code | 72703-4797 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639185341 | Michael Waggoner | Optometrist | 2630 E Citizens Dr Ste 6, Fayetteville, AR 72703-4797 | 2006-08-01 |
| 1154811412 | Johnson Chiropractic Center, LLC | Chiropractor | 2630 E Citizens Dr Ste 6, Fayetteville, AR 72703-4797 | 2018-05-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477154391 | Margaret Sorrells | Pharmacist | 3909 N Mall Ave Attn:pharmacy, Fayetteville, AR 72703 | 2020-11-06 |
| 1497369631 | Justin A Rand | Massage Therapist | 88 W Colt Square Dr, Fayetteville, Ar 72703, Fayetteville, AR 72703 | 2020-09-04 |
| 1235777558 | Washington Regional Medical System | Specialist | 3264 N North Hills Blvd, Fayetteville, AR 72703 | 2019-12-17 |
| 1760024582 | Haley Brooke Thompson | Occupational Therapist | 2474 E Joyce Blvd Ste 2, Null, Fayetteville, AR 72703 | 2019-10-14 |
| 1306492129 | Bhg L, LLC | Clinic/Center | 8 Colt Square Drive, Fayetteville, AR 72703 | 2019-08-16 |
| 1306406269 | Idell Marie Mitchell | Optometrist | Eye Clinic, 1100 N College Ave, Fayetteville, AR 72703 | 2019-06-13 |
| 1821574815 | Toni Myer | Nurse Practitioner | 3 E Appleby Rd Ste 101, Fayetteville, AR 72703 | 2018-07-13 |
| 1306340393 | Josh Kelfer | Student in an Organized Health Care Education/Training Program | 1125 North College Avenue, Fayetteville, AR 72703 | 2018-03-22 |
| 1649726449 | Vantage Point of Nwa | Community/Behavioral Health | 4171 N. Crossover Rd, Fayetteville, AR 72703 | 2016-08-31 |
| 1386097137 | Jason Nordstrom | Speech-Language Pathologist | 2664 N Valencia Ave, Fayetteville, AR 72703 | 2016-07-18 |
| Find all providers in zip 72703 | ||||
| Taxonomy Code | 302R00000X |
| Grouping | Managed Care Organizations |
| Classification | Health Maintenance Organization |
| (1) A form of health insurance in which its members prepay a premium for the HMO’s health services which generally include inpatient and ambulatory care. For the patient, an HMO means reduced out-of-pocket costs (i.e. no deductible), no paperwork (i.e. insurance forms), and only a small copayment for each office visit to cover the paperwork handled by the HMO; (2) A organization of health care personnel and facilities that provides a comprehensive range of health services to an enrolled population for a fixed sum of money paid in advance for a specified period of time. These health services include a wide variety of medical treatments and consults, inpatient and outpatient hospitalization, home health service, ambulance service, and sometimes dental and pharmacy services. The HMO may be organized as a group model, an individual practice association (IPA), a network model or a staff model. |
| Notes: Source: (1) Medical Interface: Managed Care A thru Z- Managed Care Terms published by Medicom International, Bronxville, New York Telephone (914) 337-5023, p. 20; (2) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 58 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972990687 | Loving Life | Health Maintenance Organization | 510 Candleberry Ct, Fayetteville, NC 28301-7901 | 2015-04-20 |
| 1194068734 | W.a. Lucky LLC. | Health Maintenance Organization | 1753 N College Ave, Ste. 100, Fayetteville, AR 72703-2650 | 2013-04-02 |
| 1942400312 | Memory Medical | Health Maintenance Organization | 129 N Vaughn Rd, Fayetteville, AR 72701-0524 | 2007-07-23 |
| 1689704108 | Hwc Therapy Center, Inc. | Health Maintenance Organization | 215 Banks Sta, Fayetteville, GA 30214-7505 | 2007-03-06 |
| 1942219720 | Carolina Treatment Center | Health Maintenance Organization | 3423 Melrose Rd, Fayetteville, NC 28304-1608 | 2006-08-07 |
| 1710350343 | Greater Image Healthcare, Inc. | Health Maintenance Organization | 401 Robeson St, Fayetteville, NC 28301-5635 | 2015-11-04 |
| 1578950739 | Loving Life | Health Maintenance Organization | 510 Candleberry Ct, Fayetteville, NC 28301-7901 | 2015-04-24 |
| 1619206646 | Murray Fork Home Care 3 | Health Maintenance Organization | 1555 Cain Rd Ste 201, Fayetteville, NC 28303-3076 | 2009-12-22 |
| 1215102918 | Golden Opportunity Homes, Inc | Health Maintenance Organization | 2520 Murchison Rd, Fayetteville, NC 28301-3566 | 2008-04-24 |
| 1447428768 | Helping Hands Adult Care | Health Maintenance Organization | 2932 Breezewood Ave, Suite 202, Fayetteville, NC 28303-5523 | 2008-02-20 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 72703 |
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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.