Active NPI
Anita F Wagner, LPT
- Physical Therapist
- Kennett Square, PA
National Provider Identifier
1043335797
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT005747L
- Practice address
- 101 E State St
Kennett Square, PA 19348-3109 - Phone
- (215) 620-9449
- Fax
- (215) 441-1335
- NPI assigned
- Mar 20, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT005747L | PA | Primary |
Addresses
Primary practice location
101 E State St
Kennett Square, PA 19348-3109
Mailing address
912 Gladwyn Rd
Warminster, PA 18974-4080
Phone (215) 441-1334
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT005747L | PA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1043335797",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "912 GLADWYN RD",
"city": "WARMINSTER",
"state": "PA",
"postal_code": "189744080",
"telephone_number": "215-441-1334",
"fax_number": "215-441-1335"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 E STATE ST",
"city": "KENNETT SQUARE",
"state": "PA",
"postal_code": "193483109",
"telephone_number": "215-620-9449",
"fax_number": "215-441-1335"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGNER",
"first_name": "ANITA",
"middle_name": "F",
"name_prefix": "Mrs.",
"credential": "LPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT005747L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kennett Square, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.