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

Stephen James Waggoner, PT

Individual provider Physical Therapist · NPI 1043895261

Stephen James Waggoner, PT is a Physical Therapist in Winston Salem, North Carolina. Licensed in North Carolina. Registered with an NPI since 2021.

Licensed in
NC
In the registry since
2021
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

190 Kimel Park Dr Ste 139
Winston Salem, NC 27103-6946
Phone: (336) 718-6931
Fax: (336) 718-3389
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence P15783 (NC)

Record details

NPI number1043895261
Entity typeIndividual (Type 1)
GenderMale
Credentials PT
Sole proprietorNo
NPI enumeratedMarch 10, 2021
Last updated in NPPESJune 16, 2021
Certification dateJune 16, 2021

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