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Deactivated NPI 1053536284 Deactivated / Inactive NPI Male Practitioner

Dr. Raymond Walter Waggoner , MD

Specialist • Columbus, OH

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Raymond Waggoner has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date April 14, 2007
NPI Deactivation Date January 31, 2024
Total Practice Duration ~17 Years of Practice (2007 – 2024)

Professional Overview & Biography Verified Profile Summary

Dr. Raymond Waggoner, MD was a registered Specialist practicing in Columbus, OH. Throughout an active medical career spanning 17 years, Dr. Waggoner provided care at the practice location at 100 OUTERBELT ST until profile deactivation on 2024-01-31.

Practice Location & Contact Primary Location

Practice Address

100 Outerbelt St
Suite A

Columbus, OH 432131527

Telephone 6147515393
Fax 6147515394
Associated Practice Facility / Clinic
🏢 Gestalt Associates, Inc. Facility NPI 1891817607

Specialty Benchmarks & Practice Insights

Comparative analytics for Specialist in Columbus, OH

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 32.6 Yrs
State Avg: 37.3 Yrs
Regional Practice Density
155 Specialists

Practicing in Columbus, OH (1444 Statewide)

Telehealth Adoption Rate
1.3% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Specialist Primary Specialty

NUCC Taxonomy Code: 174400000X

State License OH 35054965

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

5 Associated Practitioners
Norman Shub , LISW

Social Worker

NPI 1053765610

Licensed Independent Social Worker

Sara Hoover , LISW

Social Worker

NPI 1063566578

Licensed Independent Social Worker

Matthew Dunatchik , LPC

Counselor - Professional

NPI 1073972568

Licensed Professional Counselor

Stephanie Lopez , LISW-S

Social Worker - Clinical

NPI 1710025184

LISWS

NPI 1932293669

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated January 31, 2024

Record deactivated on January 31, 2024

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 100 OUTERBELT ST, SUITE A, COLUMBUS, OH 432131527 (Tel: 6147515393)

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Updated Business Mailing Address July 08, 2007

Registered at 979 NOTCHBROOK DR, DELAWARE, OH 430157995 (Tel: 7405484448)

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Provider Name / Credentials Updated July 08, 2007

Recorded as RAYMOND WAGGONER, M.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Specialist (License #35054965 in OH)

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Initial NPI Registration & Enumeration April 14, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1053536284
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 14, 2007
Last Update: July 08, 2007
Deactivation Date: January 31, 2024

Mailing Address

979 Notchbrook Dr

Delaware, OH 430157995

Phone: 7405484448

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.