Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mackenzie Ann Waggoner, PT

Individual provider Physical Therapist · NPI 1891295549

Mackenzie Ann Waggoner, PT is a Physical Therapist in Private Practice in Lebanon, Tennessee. Qualified in 2017, 9 years ago. Practices with Elite Sports Medicine and Orthopaedic Center PLC, a 89-clinician group and accepts Medicare assignment. Licensed in Tennessee.

Years since qualifying
9
Licensed in
TN
In the registry since
2018
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

1035 S Hartmann Dr
Lebanon, TN 37090-4064
Phone: (615) 321-3310
Fax: (615) 443-5488
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 12258 (TN)

Record details

NPI number1891295549
Entity typeIndividual (Type 1)
GenderFemale
Credentials PT
Sole proprietorNo
NPI enumeratedFebruary 20, 2018
Last updated in NPPESOctober 26, 2023
Certification dateOctober 26, 2023
Mailing addressPo Box 306556, Nashville, TN 37230-6556

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Elite Sports Medicine And Orthopaedic Center Plc — 89 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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