CHAD WADDELL PA-C
Complete NPI Record 1053960914
Physician Assistant - Medical in North Augusta, SC
Active since September 04, 2019PECOS EnrolledAccepts Medicare Assignment
94.05/100
CMS Quality Rating
Complete NPI Dataset
This page contains the complete raw NPPES record for Chad Waddell, PA-C (NPI 1053960914), an individual physician assistant provider in North Augusta, SC. All 24 fields on file are listed with their current values and official NPPES definitions, exactly as recorded in the National Plan and Provider Enumeration System. Only fields that contain data are included, so the number of fields shown varies from one NPI record to another.
Use the tools below to filter fields by category, search within the record, or jump straight to a specific field. You can download the full record as a CSV, JSON, or text file, or filter first and export only the fields you need. The Print Clean Summary button produces a printer-friendly copy of the record.
Registry File Document Utilities
- NPI: 1053960914 Field 1/24
- The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
- Entity Type Code: 1 Field 2/24
- Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
- Provider Last Name Legal Name: WADDELL Field 3/24
- The last name of the provider. If the provider is an individual, this is the legal name.
- Provider First Name: CHAD Field 4/24
- The first name of the provider, if the provider is an individual.
- Provider Credential Text: PA-C Field 5/24
- The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
- Provider First Line Business Mailing Address: PO BOX 1705 Field 6/24
- The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
- Provider Business Mailing Address City Name: AUGUSTA Field 7/24
- The city name in the mailing address of the provider being identified.
- Provider Business Mailing Address State Name: GA Field 8/24
- The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
- Provider Business Mailing Address Postal Code: 309031705 Field 9/24
- The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
- Provider Business Mailing Address Country Code If outside U S : US Field 10/24
- The country code in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address country code".
- Provider Business Mailing Address Telephone Number: 7067747263 Field 11/24
- The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
- Provider Business Mailing Address Fax Number: 7067747230 Field 12/24
- The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
- Provider First Line Business Practice Location Address: 107 WALNUT LN Field 13/24
- The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
- Provider Business Practice Location Address City Name: NORTH AUGUSTA Field 14/24
- The city name in the location address of the provider being identified.
- Provider Business Practice Location Address State Name: SC Field 15/24
- The State code in the location of the provider being identified.
- Provider Business Practice Location Address Postal Code: 298608629 Field 16/24
- The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
- Provider Business Practice Location Address Country Code If outside U S : US Field 17/24
- The country code in the location address of the provider being identified.
- Provider Business Practice Location Address Telephone Number: 8032027110 Field 18/24
- The telephone number associated with the location address of the provider being identified.
- Provider Gender Code: M Field 21/24
- The code designating the provider's gender if the provider is a person.
- Healthcare Provider Taxonomy Code 1: 363AM0700X Field 22/24
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Healthcare Provider Primary Taxonomy Switch 1: Y Field 23/24
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Is Sole Proprietor: N Field 24/24
- Indicates whether the provider is registered as a sole proprietor. This is a single-character code: "Y" means the provider operates as a sole proprietor, and "N" means they do not.
Secondary Practice Locations 10
The first line of the secondary practice location address of the provider being identified. For providers with more than one physical location, this is a secondary practice location address. This address cannot include a Post Office box.
1021 Silver Bluff Rd
Location 1/10Aiken, SC 29803-5879 · Phone (803) 648-0587 · Fax (803) 648-9846
325 Georgia Ave Ste 100
Location 2/10North Augusta, SC 29841-3848 · Phone (803) 202-3351 · Fax (803) 819-8532
3515 Richland Ave
Location 3/10Aiken, SC 29801-6311 · Phone (803) 642-2626 · Fax (803) 642-2960
447 N Belair Rd Ste 101
Location 4/10Evans, GA 30809-3091 · Phone (706) 854-2222 · Fax (706) 854-2226
925 Branch Ct
Location 5/10Grovetown, GA 30813-3325 · Phone (706) 396-1199 · Fax (706) 396-1452
925 Branch Ct Ste 101
Location 6/10Grovetown, GA 30813-3325 · Phone (706) 396-1199 · Fax (706) 396-1452
447 N Belair Rd
Location 7/10Evans, GA 30809-3090 · Phone (706) 854-2222 · Fax (706) 854-2226
3486 Peach Orchard Rd Ste 200
Location 8/10Augusta, GA 30906-5215 · Phone (706) 828-8049 · Fax (706) 828-8048
4720 Washington Rd
Location 9/10Evans, GA 30809-5875 · Phone (706) 650-0111 · Fax (706) 651-1882
1100 W Lake Commons Dr
Location 10/10Martinez, GA 30907-7932 · Phone (706) 250-6919 · Fax (706) 250-7232
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