KEITH WAGGONER (MD) – Emergency Medicine Physician, NPI 1225015050

KEITH WAGGONER (MD) is a healthcare provider. based in Hudson, Ohio. specializing in EMERGENCY MEDICINE. They hold the professional credentials MD. They hold a License No. 18247 (WV). The NPI Number for KEITH WAGGONER (MD) is 1225015050

Main info

Male
39 Years Of Experience
Accepts Medicare Assignment
Name
KEITH WAGGONER (MD)
NPI
1225015050
Phone
(330) 656-5911
Address
5700 DARROW RD
Enumeration Date
22 December 2005
Last Update Date
12 June 2008

Doctor Profile

Medical School Name
UNIVERSITY OF MISSISSIPPI SCHOOL OF MEDICINE
Secondary Phone
3304934443
Graduation Year
1987 (39 years ago)
PAC ID
5991774556
Group Practice PAC ID
4587807854
Professional Enrollment ID
I20120508000729
Address ID
OH440302039CO158XXRDXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

527 EMERGENCY MEDICINE in WV

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Provider Addresses for KEITH WAGGONER (MD)

  • 5700, Darrow Road, Hudson, Summit County, Ohio, 44236, United States

    SUITE 106

    HUDSON, OH 442365021

    Phone: (330) 656-5911

    Fax: (330) 656-5901

    Type: Mailing

  • 1824, Murdoch Avenue, Beechwood, North Parkersburg, Parkersburg, Wood County, West Virginia, 26101, United States

    PARKERSBURG, WV 261013230

    Phone: (304) 424-4111

    Fax: (330) 656-5901

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2012-05-08

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20120508000729IEmergency MedicineOHTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99285Emergency department visit with high level of medical decision making149142$0
99284Emergency department visit with moderate level of medical decision making10295$0
93010Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only2119$0
99283Emergency department visit with low level of medical decision making1817$0
99291Critical care, first 30-74 minutes1818$0
View full utilization report →

Insurance plans in this area (ZIP 44236)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4587807854View full group profile
NameSpecialtyState
Emergency MedicinePA
-NY
Emergency MedicineOH
Emergency MedicineOH
-OH
-FL
Emergency MedicineOH
Emergency MedicineOH
Emergency MedicineOH
Family Practice, Emergency MedicineOH

Reviews

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Frequently asked questions

How do payers reference KEITH WAGGONER (MD)?
For KEITH WAGGONER (MD), use NPI 1225015050 as the unique 10-digit identifier.
Active or inactive — what applies to KEITH WAGGONER (MD)?
You should see KEITH WAGGONER (MD) as active in CMS-hosted NPPES data.
What expertise is attributed to KEITH WAGGONER (MD)?
KEITH WAGGONER (MD)'s specialty line reads Emergency Medicine Physician. Clinical services aligned with this taxonomy classification.
Is KEITH WAGGONER (MD) located near Hudson?
KEITH WAGGONER (MD) currently maps to Hudson, Ohio in this extract.
When was this NPI issued?
Enumeration for KEITH WAGGONER (MD) is noted as December 22, 2005 where the registry provides it.

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