Active NPI
Ronald W Wagner, PT, DPT
- Physical Therapist
- Atchison, KS
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 11-03052
- Practice address
- 415 S 10TH St
Atchison, KS 66002-2771 - Phone
- (913) 370-9500
- Fax
- (913) 367-5061
- NPI assigned
- May 3, 2019
- Sex
- Male
- Sole proprietor
- No
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 | 11-03052 | KS | Primary |
Addresses
Primary practice location
415 S 10TH St
Atchison, KS 66002-2771
Mailing address
6397 Lee Hwy Ste 300
Chattanooga, TN 37421-4915
Phone (423) 238-7217
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KS
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- University of Kansas School of Med (KC/Wich/Sal), 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
415 S 10TH St
Serc Atchison
Atchison, KS 66002-2771
Phone (913) 370-9501
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11-03052 | KS | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Serc Rebabilitation Partners, LLC | Physical Therapist | Current | Accepting new patients |
| Serc Rehabilitation Partners, LLC | Physical Therapist | Current | Accepting new patients |
Locations
1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568
415 S 10th St
Atchison, KS 66002
Phone (913) 370-9501
13035 Kansas Ave
Bonner Springs, KS 66012
Phone (913) 721-6362
6397 Lee Hwy
Ste 300
Chattanooga, TN 37421
Phone (423) 238-8923
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 and National Provider Directory roles.
-
- Physical Therapist
- Overland Park, KS
- NPI 1598190209
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1556841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1556841600000",
"number": "1306401567",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6397 LEE HWY STE 300",
"city": "CHATTANOOGA",
"state": "TN",
"postal_code": "374214915",
"telephone_number": "423-238-7217",
"fax_number": "423-238-3473"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "415 S 10TH ST",
"city": "ATCHISON",
"state": "KS",
"postal_code": "660022771",
"telephone_number": "913-370-9500",
"fax_number": "913-367-5061"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGNER",
"first_name": "RONALD",
"middle_name": "W",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-05-03",
"last_updated": "2019-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "KS",
"license": "11-03052",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Atchison, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.