Active NPI
John Wagner, D.P.T.
- Physical Therapist
- Laguna Beach, CA
National Provider Identifier
1326323221
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 38080
- Practice address
- 3079 Nestall Rd
Laguna Beach, CA 92651-2026 - Phone
- (949) 295-7133
- NPI assigned
- Oct 12, 2011
- Sex
- Male
- Sole proprietor
- Yes
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 | 38080 | CA | Primary |
Addresses
Primary practice location
3079 Nestall Rd
Laguna Beach, CA 92651-2026
Mailing address
3079 Nestall Rd
Laguna Beach, CA 92651-2026
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 38080 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1318377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318377600000",
"number": "1326323221",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3079 NESTALL RD",
"city": "LAGUNA BEACH",
"state": "CA",
"postal_code": "926512026"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3079 NESTALL RD",
"city": "LAGUNA BEACH",
"state": "CA",
"postal_code": "926512026",
"telephone_number": "949-295-7133"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGNER",
"first_name": "JOHN",
"credential": "D.P.T.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-10-12",
"last_updated": "2011-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "38080",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Laguna Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.