Cecyle Wagner, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

CP024217T Issued in VA

Practice address

8550 Lee Hwy Ste 450
Fairfax, VA 22031-1519

Phone

(703) 208-1002

Fax

(703) 208-1127

NPI assigned

May 19, 2021

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

Enrolled in AZ, DC, VA3 enrollments

Enrollment records 3

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Jackson Clinics Limited Partnership

  • Physical Therapist
  • Centreville, VA
  • NPI 1639594831

  DC

  Medicare reassignment NPD
• Strength Training Inc

  dba STi Therapy Division

  • Physical Therapist
  • Phoenix, AZ
  • NPI 1518925569
  Medicare reassignment NPD
• The Jackson Clinics LLC

  • Physical Therapist
  • Middleburg, VA
  • NPI 1427034982
  NPD (past)
• Strength Training Inc

  dba STI Therapy Division

  • Customized Equipment (DME)
  • Phoenix, AZ
  • NPI 1356552996
  NPD (past)

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

{
    "created_epoch": "1621382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1306410857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "706 N WILLIAMS",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852036639",
            "telephone_number": "480-282-0449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8550 LEE HWY STE 450",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220311519",
            "telephone_number": "703-208-1002",
            "fax_number": "703-208-1127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "CECYLE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-19",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "LPT-31756",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "14660",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "CP024217T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karianne Lynne Wade
• Raymond C Wadlow, MD
• Barbara Jane Wagar, PSY.D.
• Johanne Mae Waggy, NP
• Wagner Psychotherapy LLC
• Diane Wagner
• Robert Harrison Wagner, MD
• Samuel Charles Wagner V, LPC
• Leina Wahba, MD
• Mira Wahba, PT

• Physical Therapist in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2023; 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.