James Blake Wagner, P.T.

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

PT2565 Issued in AR

Practice address

1525 Country Club Rd
Sherwood, AR 72120-5076

Phone

(501) 978-3135

Fax

(501) 978-3138

NPI assigned

May 1, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Orthoarkansas PAGroup PAC ID 1456256031, 148 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: james.wagner.1@1376.direct.athenahealth.com

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.

• Orthoarkansas, PA

  • Specialist
  • Little Rock, AR
  • NPI 1952336869
  Medicare reassignment Care Compare group NPD
• Orthoarkansas, PA

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Little Rock, AR
  • NPI 1861459315
  NPD

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394496000000",
    "number": "1306804448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 COUNTRY CLUB RD",
            "city": "SHERWOOD",
            "state": "AR",
            "postal_code": "721205076",
            "telephone_number": "501-978-3135",
            "fax_number": "501-978-3138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 COUNTRY CLUB RD",
            "city": "SHERWOOD",
            "state": "AR",
            "postal_code": "721205076",
            "telephone_number": "501-978-3135",
            "fax_number": "501-978-3138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "JAMES",
        "middle_name": "BLAKE",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-01",
        "last_updated": "2014-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "AR",
            "license": "PT2565",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "AR",
            "license": "PT2565",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AR BLUE CROSS BLUE SHIELD",
            "identifier": "5W797C153",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark Richard Varley, DC
• Megan Vaughn, M.S.
• Audrey Elizabeth Vesperman, SLP
• W David Hill DDS PA
• Reagan Wade
• Wal-Mart Stores, Inc.
• Wal-Mart Stores, Inc.
• Walgreen Co
• Debra Kaitlin Walker
• Hazel Marie Walker

• Orthopedic Physical Therapist in Sherwood, AR
• Providers in Sherwood, AR by specialty
• Orthopedic Physical Therapist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2014; 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.

Verify at the official NPI Registry.