Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

SHANNON MAYHEW WAGGONER FNP-C
NPI 1629653670
Nurse Practitioner - Family in Statesville, NC

Active since March 11, 2021PECOS EnrolledAccepts Medicare Assignment
700 SULLIVAN RD, STATESVILLE, NC 28677(704) 924-9111(704) 883-0452 Get Directions Write a Review

NPPES record last updated: October 15, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Oct 15, 2026, Aug 10, 2023, Mar 11, 2021 (3 updates tracked since 2021).

About Shannon Mayhew Waggoner Fnp-c NPPES

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

SHANNON MAYHEW WAGGONER FNP-C (NPI 1629653670) is an individual family provider in Statesville, North Carolina, licensed in North Carolina (5014171) and active in the NPI registry since March 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1629653670
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameSHANNON MAYHEW WAGGONERCredential: FNP-C
Location Address700 SULLIVAN RDStatesville, NC 28677-3440
Mailing AddressPo Box 1845Statesville, NC 28687-1845 · (704) 873-4277
Fax(704) 883-0452
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateMarch 11, 2021
Last NPPES UpdateOctober 15, 20263 updates tracked since enumeration
NPPES CertifiedOctober 15, 2026
✔ NPI 1629653670 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in NC · 5014171
700 SULLIVAN RD, Statesville, NC 28677

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Shannon Mayhew Waggoner Fnp-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8628485984
PECOS Enrollment IDI20210402000233
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.

Medicare Billing Reassignment

Medicare enrollment records show Shannon Waggoner reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Internal Medicine
650 SIGNAL HILL DRIVE EXT
Statesville, NC 28625
  • Reassigned Medicare billing, North Carolina enrollment
  • Medicare enrollment name: Piedmont Healthcare PA
  • 186 clinicians in this Medicare group

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 18

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml Q9967
Low osmolar contrast material with 300-399 mg/ml iodine concentration is a diagnostic tool used in imaging procedures. It helps to enhance the visibility of specific areas in the body, aiding in accurate diagnosis. It's safe and generally well-tolerated by patients.
2,685 services28 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
512 services376 patients
Ultrasound measurement of bladder capacity after voiding 51798
Ultrasound measurement of bladder capacity after voiding is a non-invasive test that uses sound waves to create images of your bladder. It's done after you've emptied your bladder to see if there's any leftover urine, which can help diagnose certain conditions.
367 services251 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
313 services235 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
196 services150 patients
Psa (prostate specific antigen) measurement, total 84153
PSA measurement is a simple blood test that checks for a specific protein produced by your body. High levels could indicate a health issue that needs further investigation. It's often used to monitor general wellness and is part of routine health screening.
189 services143 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28677 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.90 typical visit price
range $54.12 – $165.09
Typical copayment $20.97 (range $13.53 – $41.27)
Most-billed visit code 99203
Established Patient
$95.94 typical visit price
range $17.21 – $134.61
Typical copayment $23.98 (range $4.30 – $33.65)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 11

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

Physician Assistant
700 SULLIVAN RD
STATESVILLE, NC 28677
Nurse Practitioner (Family)
700 SULLIVAN RD
STATESVILLE, NC 28677
Physician Assistant
700 SULLIVAN RD
STATESVILLE, NC 28677
Family Medicine
700 SULLIVAN RD
STATESVILLE, NC 28677
Family Medicine
700 SULLIVAN RD
STATESVILLE, NC 28677
Nurse Practitioner (Family)
700 SULLIVAN RD
STATESVILLE, NC 28677
Physician Assistant
700 SULLIVAN RD
STATESVILLE, NC 28677
Nurse Practitioner (Adult Health)
700 SULLIVAN RD
STATESVILLE, NC 28677

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 Shannon Waggoner's NPI number?

The NPI number for Shannon Waggoner is 1629653670. It was assigned to this individual provider in the NPPES registry on March 11, 2021.

Where is Shannon Waggoner located?

Shannon Waggoner practices at 700 Sullivan Rd, Statesville, NC 28677. The listed phone number is (704) 924-9111.

What is Shannon Waggoner's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Shannon Waggoner enrolled in Medicare?

Yes. Shannon Waggoner is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Shannon Waggoner's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Shannon Waggoner reassigns Medicare benefits to Piedmont Healthcare, P.A. (Statesville, NC). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Shannon Waggoner's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Shannon Waggoner accept?

Health plans from UnitedHealthcare list Shannon Waggoner as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Shannon Waggoner was last updated on October 15, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 days 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.