MRS. PHYLLIS THORNTON WAGGONER NP-C
NPI 1831542190
Nurse Practitioner - Family in Mechanicsville, VA
About Mrs. Phyllis Thornton Waggoner Np-c NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MRS. PHYLLIS THORNTON WAGGONER NP-C (NPI 1831542190) is an individual family provider in Mechanicsville, Virginia, licensed in Virginia (0024173765) and active in the NPI registry since July 2016. She is enrolled in Medicare PECOS and is a graduate of Other (2016).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mrs. Phyllis Thornton Waggoner Np-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
5Medicare enrollment records show Phyllis Waggoner reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Midlothian, VA 23114
- Reassigned Medicare billing, Virginia enrollment
- 16 clinicians in this Medicare group
Charlottesville, VA 22901
- Reassigned Medicare billing, Virginia enrollment
- 12 clinicians in this Medicare group
Charlottesville, VA 22901
- Reassigned Medicare billing, Virginia enrollment
- 19 clinicians in this Medicare group
Leesburg, VA 20176
- Reassigned Medicare billing, District of Columbia and Virginia enrollments
- 266 clinicians in this Medicare group
Monroeville, PA 15146
- Reassigned Medicare billing, Virginia enrollment
- 7 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 23111 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Referred Medical Equipment & Supplies CMS DME claims 2
Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.
Other Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
MECHANICSVILLE, VA 23111
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 Phyllis Waggoner's NPI number?
The NPI number for Phyllis Waggoner is 1831542190. It was assigned to this individual provider in the NPPES registry on July 21, 2016.
Where is Phyllis Waggoner located?
Phyllis Waggoner practices at 8015 Cold Harbor Rd, Mechanicsville, VA 23111. The listed phone number is (800) 640-3451.
What is Phyllis Waggoner's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Phyllis Waggoner enrolled in Medicare?
Yes. Phyllis Waggoner is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Phyllis Waggoner's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Phyllis Waggoner reassigns Medicare benefits to 5 organizations: Family Practice Associates Of Chesterfield PC (Midlothian, VA), Advanced Mobile Wound Care Of Virginia LLC (Charlottesville, VA), Scott Wagner Integrated Medicine LLC (Charlottesville, VA), Minuteclinic Diagnostic Of Virginia LLC (Leesburg, VA) and Plaid Eagle Medical PLLC (Monroeville, PA). Each 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 Phyllis Waggoner's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Phyllis Waggoner was last updated on June 24, 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.
# Mrs. Phyllis Thornton Waggoner, NP-C · NPI 1831542190
Family physician in Mechanicsville, Virginia. Individual provider, active in the CMS NPPES registry since July 21, 2016.
## Identity
- **NPI:** 1831542190 (Entity type: Individual)
- **Enumerated:** July 21, 2016
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 0024173765 (Virginia)
- **Sole proprietor:** No
## Practice location
- **Address:** 8015 COLD HARBOR RD, Mechanicsville, VA 23111-1650
- **Phone:** (800) 640-3451
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 5 organizations under Medicare reassignment (form CMS-855R): Family Practice Associates Of Chesterfield PC (NPI 1306884820, Midlothian, VA); Advanced Mobile Wound Care Of Virginia LLC (NPI 1174324610, Charlottesville, VA); Scott Wagner Integrated Medicine LLC (NPI 1447875042, Charlottesville, VA); Minuteclinic Diagnostic Of Virginia LLC (NPI 1417076829, Leesburg, VA); Plaid Eagle Medical PLLC (NPI 1588417117, Monroeville, PA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2016
## Record status
- **NPPES last updated:** June 24, 2025
---
Source: [NPI Profile](https://npiprofile.com/npi/1831542190) · Data from the CMS NPPES public registry.