Leslie Dawn Wagner

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

TA841 Issued in OK

Practice address

10001 S Western Ave Ste 102
Oklahoma City, OK 73139-2997

Phone

(405) 691-5434

Fax

(405) 692-3703

NPI assigned

Aug 24, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1692835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692835200000",
    "number": "1295519601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10001 S WESTERN AVE STE 102",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731392997",
            "telephone_number": "405-691-5434",
            "fax_number": "405-692-3703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10001 S WESTERN AVE STE 102",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731392997",
            "telephone_number": "405-691-5434",
            "fax_number": "405-692-3703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "LESLIE",
        "middle_name": "DAWN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-24",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": "TA841",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OK",
            "license": "841",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OK",
            "license": "TA841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Wagner, PHARMD
• Heather Wagner
• Jack C Wagner
• Janelle Wagner, APRN
• Jason Michael Wagner, MD
• Mariah Nicole Wagner, DPT
• Michael Donald Wagner, M.D.
• Veronica Wagner, LPN
• Tammy L Wagstaff, APRN-CNP
• Gennifer Wahbah Makhoul, M.D.

• Physical Therapy Assistant in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Physical Therapy Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2023; 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.