MR. KENNETH RAY WAGGONER (NPI# 1518038041) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518038041 |
| Entity Type | Individual |
| Full Name | MR. KENNETH RAY WAGGONER |
| Credential | LPC, LADC |
| Practice Address |
4301 Mow-way Road Fort Sill OK 73503-6300 |
| Mailing Address |
2103 Nw 55th St Lawton OK 73505-3117 |
| Practice Telephone | 5804582134 |
| Mailing Telephone | 5802485425 |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
415 | OK | Behavioral Health & Social Service Providers |
| Street Address |
4301 MOW-WAY ROAD |
| City | FORT SILL |
| State | OK |
| Zip Code | 73503-6300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821097353 | Daniel Patrick Flynn | Podiatrist | 4301 Mow-way Road, Fort Sill, OK 73503-6300 | 2005-07-18 |
| 1245381037 | Robert Lee Hornsby | Family Medicine | 4301 Mow-way Road, Reynolds Army Community Hospital (attn Ms. Prescott), Fort Sill, OK 73503-6300 | 2007-01-16 |
| 1750449989 | James Anthony Hapka | Physician Assistant | 4301 Mow-way Road, Reynolds Army Community Hospital (attn Ms. Prescott), Fort Sill, OK 73503-6300 | 2006-12-04 |
| 1558429787 | Carolyn Spence Patterson | Registered Nurse | 4301 Mow-way Road, Reynolds Army Community Hospital (attn Ms Prescott), Fort Sill, OK 73503-6300 | 2006-12-04 |
| 1972673952 | Marcia Louise Folkes | Social Worker | 4301 Mow-way Road, Reynolds Army Community Hospital (attn Ms Ruby Prescott, Fort Sill, OK 73503-6300 | 2006-11-08 |
| 1437235454 | Gerald P Vaughan | Pharmacist | 4301 Mow-way Road, Reynolds Army Community Hospital, Fort Sill, OK 73503 | 2006-10-31 |
| 1063598910 | Michael Joseph Gill | Pharmacist | 4301 Mow-way Road, Reynolds Army Community Hospital (attn: Mcua-qc), Fort Sill, OK 73503-6300 | 2006-10-31 |
| 1386729523 | Marty Jeanne Bennett | Pharmacist | 4301 Mow-way Road, Reynolds Army Community Hospital (attn:ms.prescott), Fort Sill, OK 73503-6300 | 2006-10-26 |
| 1144304296 | James Michael Ptacek | Family Medicine | 4301 Mow-way Road, Reynolds Army Community Hospital (attn:ms Prescott), Fort Sill, OK 73503-6300 | 2006-10-25 |
| 1760567176 | Gary D Compton | Pharmacist | 4301 Mow-way Road, Reynold Army Community Hospital, Fort Sill, OK 73503-6300 | 2006-10-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942824446 | Alex Boyd | Dentist | U.S.A. Dental Health Activity, 652 Hamilton Road, Fort Sill, OK 73503 | 2020-06-01 |
| 1588145031 | Dustin Davis | Dentist | Usa Dental Health Activity 652 Hamilton Rd., Fort Sill, OK 73503 | 2018-08-23 |
| 1578086492 | Austin Kent Brown | Dentist | Usa Dental Activity 652 Hamilton Rd., Fort Sill, OK 73503 | 2017-07-23 |
| 1083155998 | Michael Gagliano | Physician Assistant | 4301 Wilson Street, Attn: Mcua-qm Credentials, Reynolds Army Health Clinic, Fort Sill, OK 73503 | 2017-03-10 |
| 1619428885 | Kristi Ann Putnam | Registered Nurse | Sgt Bleak Troop Medical Clinic, 6039 Berry Street, Fort Sill, OK 73503 | 2016-10-21 |
| 1003265901 | Lucy Muller | Registered Nurse | 4301 Wilson Road, Ft Sill, OK 73503 | 2016-06-10 |
| 1356740146 | Gregory B Kiene | Dentist | 642 Hamilton Rd, Usa Dental Activity, Fort Sill, OK 73503 | 2014-08-18 |
| 1295152262 | Cheryl Marie Wildman | Dental Assistant | 2640 Miner Road, Weeks Dental Clinic, Ft Sill, OK 73503 | 2014-03-27 |
| 1245664143 | Tina L Gray | Dentist | 652 Hamilton Road, Suite 210, Fort Sill Dentac, Fort Sill, OK 73503 | 2013-08-27 |
| 1720410533 | Katherine Loi | Dentist | 652 Hamilton Rd, Fort Sill Dentac, Suite 210, Fort Sill, OK 73503 | 2013-08-02 |
| Find all providers in zip 73503 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417900341 | Francis Paul Jette | Counselor | 4301 Wilson Street, Rahc Sudcc, Fort Sill, OK 73503-6300 | 2006-05-19 |
| 1104109198 | Polly Jane Guthrie | Counselor | 4301 Wilson St, Reynolds Army Community Hospital, Fort Sill, OK 73503-4472 | 2011-09-26 |
| 1740586155 | Sophia Olaitan Oyetunbi | Counselor | 4301 Wilson Street, Fort Sill, OK 73503-9042 | 2011-02-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295341337 | Juan Miguel Jimenez | Counselor | 713 Nw 139th St, Edmond, OK 73013-1912 | 2020-09-22 |
| 1790396042 | Amazing Life Behavioral Health and Addiction Services | Counselor | 324 N 19th St Ste 101, Guthrie, OK 73044-2117 | 2020-08-11 |
| 1144839994 | Jill Brittny Johnson | Counselor | 2840 Nw 31st St, Oklahoma City, OK 73112-7407 | 2020-07-28 |
| 1417565243 | Angela Darlene Brooks | Counselor | 3605 Ne 142nd Ct, Edmond, OK 73013-7224 | 2020-07-17 |
| 1285252304 | Max Anna Hanna | Counselor | 2600 W. Coffee Creek Rd, Edmond, OK 73025 | 2020-07-07 |
| 1366060444 | John Christopher Lewis | Counselor | 6302 N Garrison Ave, Tulsa, OK 74126-1512 | 2020-07-06 |
| 1710502505 | Sally Smith | Counselor | 4525 Southcreek Rd, Moore, OK 73165-7359 | 2020-06-08 |
| 1487273223 | Maxwell Brown Enterprise, LLC | Counselor | 250 E Apache St, Tulsa, OK 74106-3702 | 2020-04-12 |
| 1679105068 | Audrey June Halfacre | Counselor | 4803 Ridge St, Tahlequah, OK 74464-5644 | 2020-02-04 |
| 1760021984 | Damilola Mosebolatan Akintola | Counselor | 5013 Oak Manor Dr, Oklahoma City, OK 73135-2235 | 2020-01-06 |
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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.