Kourtney Waggoner, PA
NPI 1265997191 · Physician Assistant · Kenmore, NY
Enrolled with Medicare as Practitioner - Physician Assistant · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Kourtney Waggoner, PA is a Physician Assistant provider in Kenmore, NY (NPI 1265997191).
Provider details
- NPI number
- 1265997191
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA
- Sex
- Female
- Sole proprietor
- No
- License
- 023195 (NY)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2019-02-05
- Last updated
- 2019-02-05
Frequently asked questions
- What is Kourtney Waggoner's NPI number?
- Kourtney Waggoner's National Provider Identifier (NPI) is 1265997191, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Kourtney Waggoner's specialty?
- Kourtney Waggoner is listed in the NPPES registry with a primary specialty of Physician Assistant (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Kourtney Waggoner located?
- Kourtney Waggoner's practice location on file with NPPES is 2950 Elmwood Ave Ste A1, Kenmore, NY 14217-1304.
- What is Kourtney Waggoner's phone number?
- The practice phone number listed in the NPPES registry for Kourtney Waggoner is (716) 529-3070.
- Does Kourtney Waggoner accept Medicare?
- Kourtney Waggoner is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Kourtney Waggoner's NPI active?
- Yes — Kourtney Waggoner's NPI (1265997191) is active in the NPPES registry as of the last update on 2019-02-05.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.