Nicholas Mark Wagner, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT2846 Issued in AR

Practice address

600 S McKinley St
Suite 210
Little Rock, AR 72205-5202

Phone

(501) 225-0181

Fax

(501) 225-0384

NPI assigned

Jun 9, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Orthoarkansas PAGroup PAC ID 1456256031, 148 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nicholas.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": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402963200000",
    "number": "1386685360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 S MCKINLEY ST",
            "address_2": "SUITE 210",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722055202",
            "telephone_number": "501-225-0181",
            "fax_number": "501-225-0384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 S MCKINLEY ST",
            "address_2": "SUITE 210",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722055202",
            "telephone_number": "501-225-0181",
            "fax_number": "501-225-0384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "NICHOLAS",
        "middle_name": "MARK",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2014-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "PT2846",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ABCBS",
            "identifier": "5Y867",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charles Wesley Wagner, MD
• Kendall Darren Wagner, M.D.
• Kristen Leigh Wagner, PA-C
• McKenna Marie Wagner, PT, DPT
• Megan Elizabeth Wagner
• Emily Wagnon
• Joyce Wagoner
• Rebecca Diane Wahrmund, PHARM.D.
• Wainwright Holistic Healthcare
• Alexandra Marie Waits, MD

• Physical Therapist in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Physical Therapist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 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.