Alexandria Physical Medicine P.S.C.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

ALEXANDRIA PHYSICAL MEDICINE P.S.C.

Practice address

6907 Alexandria Pike
Alexandria, KY 41001-1029

Phone

(859) 448-0056

Fax

(859) 448-0156

NPI assigned

Nov 18, 2013

Last updated

Feb 10, 2016By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Michael Paul Wagner, D.C.NPI 1619159084

Title

Manager

Phone

(859) 448-0056

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in KY2 enrollments

Enrollment records 2

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Northern Kentucky Pain Relief Physical Medicine Center PSC

  • Nurse Practitioner
  • Florence, KY
  • NPI 1649554031

  O20111209000501

  Same enrollment

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Neck Back & Knee Center II PSC

  • Nurse Practitioner
  • Florence, KY
  • NPI 1003593401

  Member Of

  NPD member

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael Paul Wagner, D.C.

  • Chiropractor
  • Glendale Heights, IL
  • NPI 1619159084

  KY

  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1384732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455062400000",
    "number": "1053741744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6907 ALEXANDRIA PIKE",
            "city": "ALEXANDRIA",
            "state": "KY",
            "postal_code": "410011029",
            "telephone_number": "859-448-0056",
            "fax_number": "859-448-0156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6907 ALEXANDRIA PIKE",
            "city": "ALEXANDRIA",
            "state": "KY",
            "postal_code": "410011029",
            "telephone_number": "859-448-0056",
            "fax_number": "859-448-0156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALEXANDRIA PHYSICAL MEDICINE P.S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-18",
        "last_updated": "2016-02-10",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "859-448-0056",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandria Durable Medical Equipment, LLC
• Alexandria Fire District
• Stephanie Lynn Anthrop, SPEECH-LANG PATH
• Brittanie S Apke, LCSW-S
• Suzanne Marie Augspurger, PT
• Keshia-Luz Munoz Bakunawa, FNP-C
• Baptist Convalescent Center, Inc. (Baptist Convalescent Center)

• Physical Medicine & Rehabilitation Physician in Alexandria, KY
• Providers in Alexandria, KY by specialty
• Physical Medicine & Rehabilitation Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.