Rachel Ann Wagner

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

101078 Issued in AK

Practice address

12812 Old Glenn Hwy
Ste A5
Eagle River, AK 99577-7002

Phone

(907) 317-9349

NPI assigned

Oct 15, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Playful Learning Pediatric Therapy, LLC

  • Pediatric Occupational Therapist
  • Eagle River, AK
  • NPI 1407129745
  NPD (past)

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

{
    "created_epoch": "1444867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444867200000",
    "number": "1104297175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12110 BUSINESS BLVD",
            "address_2": "STE 6 PMB 413",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995777741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12812 OLD GLENN HWY",
            "address_2": "STE A5",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995777002",
            "telephone_number": "907-317-9349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "RACHEL",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-15",
        "last_updated": "2015-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AK",
            "license": "101078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Volunteers of America Alaska
• Volunteers of America Alaska, Arch 1115
• Danna Lee Voyer
• Hanna Michelle Wade, MSW
• Maria Wade, PT
• Wal-Mart Stores, Inc.
• Walgreen Co
• Dennis C Walker
• Terrell Walker
• Gina Thara Wall, LPC

• Physical Therapy Assistant in Eagle River, AK
• Providers in Eagle River, AK by specialty
• Physical Therapy Assistant in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2015; 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.