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DR. KIMBERLY ANNE WAGGENER MD
NPI 1073316691
Student in an Organized Health Care Education/Training Program in Winston Salem, NC

Active since March 29, 2025PECOS Enrolled
ONE MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157(336) 716-4241 Get Directions Write a Review

NPPES record last updated: March 29, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Kimberly Anne Waggener Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KIMBERLY ANNE WAGGENER MD (NPI 1073316691) is an individual student in an organized health care education/training program in Winston Salem, North Carolina, licensed in North Carolina (RTL25-0048) and active in the NPI registry since March 2025. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1073316691
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameDR. KIMBERLY ANNE WAGGENERCredential: MD
Location AddressONE MEDICAL CENTER BLVDWinston Salem, NC 27157-0001
Mailing AddressOne Medical Center BlvdWinston Salem, NC 27157-0001
Phone(336) 716-4241
Sole ProprietorNo
Enumeration DateMarch 29, 2025
NPPES CertifiedMarch 29, 2025
✔ NPI 1073316691 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
License✔ Licensed in NC · RTL25-0048
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
ONE MEDICAL CENTER BLVD, Winston Salem, NC 27157
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Kimberly Anne Waggener Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ANNA LARUSSA MD
Student in an Organized Health Care Education/Training Program
ONE MEDICAL CENTER BLVD
WINSTON SALEM, NC 27157
Forsyth County (855) 799-0044
DR. JARED JOSEPH TUTTLE MD
Student in an Organized Health Care Education/Training Program
ONE MEDICAL CENTER BLVD
WINSTON SALEM, NC 27157
Forsyth County (336) 716-4091
CESAR ANDRES URIZAR-GONZALEZ MD
Student in an Organized Health Care Education/Training Program
ONE MEDICAL CENTER BLVD
WINSTON SALEM, NC 27157
Forsyth County (336) 713-7527
HOLDEN BRADLY LEWIS
Student in an Organized Health Care Education/Training Program
ONE MEDICAL CENTER BLVD
WINSTON SALEM, NC 27157
Forsyth County (336) 716-7580
HONGSHENG LU MD
Student in an Organized Health Care Education/Training Program
ONE MEDICAL CENTER BLVD
WINSTON SALEM, NC 27157
Forsyth County (336) 713-7527
RAED WALEED ALI ALKHADDASH
Student in an Organized Health Care Education/Training Program
ONE MEDICAL CENTER BLVD
WINSTON SALEM, NC 27157
Forsyth County (336) 716-7548
PEMBROKE NASH III
Student in an Organized Health Care Education/Training Program
ONE MEDICAL CENTER BLVD
WINSTON SALEM, NC 27157
Forsyth County (336) 716-2011
IAN ALASDAIR SEDDON DO
Student in an Organized Health Care Education/Training Program
ONE MEDICAL CENTER BLVD
WINSTON SALEM, NC 27157
Forsyth County (336) 716-4490

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kimberly Waggener's NPI number?

The NPI number for Kimberly Waggener is 1073316691. It was assigned to this individual provider in the NPPES registry on March 29, 2025.

Where is Kimberly Waggener located?

Kimberly Waggener practices at One Medical Center Blvd, Winston Salem, NC 27157. The listed phone number is (336) 716-4241.

What is Kimberly Waggener's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Kimberly Waggener enrolled in Medicare?

Yes. Kimberly Waggener is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kimberly Waggener was last updated on March 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.