Individual provider Active NPI

Sandra Wagers, PTA

  • Physical Therapy Assistant
  • Gary, IN
National Provider Identifier
1093346108
Registry record updated Jan 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
06006001A Issued in IN
Practice address
6100 Miller Ave
Gary, IN 46403-2469
Phone
(219) 427-0196
NPI assigned
Jan 28, 2020
Last updated
Jan 28, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 06006001A IN Primary

Addresses

Primary practice location

6100 Miller Ave
Gary, IN 46403-2469

Mailing address

6100 Miller Ave
Gary, IN 46403-2469
Phone (219) 427-0196

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
06006001AINMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Restore Therapy Services LLC CurrentSince Feb 2, 2020 Accepting new patients
Next Level Therapeutic Services LLP PastSince Feb 2, 2020 Accepting new patients

Locations

6100 Miller Ave
Gary, IN 46403
Phone (219) 427-0196

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1580169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580169600000",
    "number": "1093346108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6100 MILLER AVE",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464032469",
            "telephone_number": "219-427-0196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6100 MILLER AVE",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464032469",
            "telephone_number": "219-427-0196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGERS",
        "first_name": "SANDRA",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-28",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IN",
            "license": "06006001A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gary, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.