Jennifer M. Wagar, MS, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

05006962A Issued in IN

Practice address

730 Kilbourne Dr
Greenwood, IN 46142-1831

Phone

(317) 607-0702

NPI assigned

Nov 6, 2006

Last updated

Sep 2, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dynamic Equilibrium IncGroup PAC ID 4789623844, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dynamic Equilibrium, Inc.

  dba Balance Institute of Indiana

  • Physical Therapist
  • Indianapolis, IN
  • NPI 1043332851
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472774400000",
    "number": "1619056967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 KILBOURNE DR",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461421831",
            "telephone_number": "317-607-0702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 KILBOURNE DR",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461421831",
            "telephone_number": "317-607-0702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGAR",
        "first_name": "JENNIFER",
        "middle_name": "M.",
        "credential": "MS, PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-06",
        "last_updated": "2016-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05006962A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Greenwood, IN
• Providers in Greenwood, IN by specialty
• Physical Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2016; 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.