Megan E Wacker, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

8955 Issued in CO

Practice address

1295 Westhaven Dr
Vail, CO 81657-4395

Phone

(970) 476-7510

Fax

(970) 476-7511

NPI assigned

Sep 22, 2008

Sex

Female

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

Other names 1

• Megan E Riddle Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Vail Physical Therapy, LLC

  • Physical Therapist
  • Vail, CO
  • NPI 1376162883
  NPD (past)
• Vail Sports Medicine Physical Therapy PC

  • Physical Therapist
  • Vail, CO
  • NPI 1508867227
  NPD (past)

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

{
    "created_epoch": "1222041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238025600000",
    "number": "1629228135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1311",
            "city": "VAIL",
            "state": "CO",
            "postal_code": "816581311",
            "telephone_number": "970-476-7510",
            "fax_number": "970-476-7511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1295 WESTHAVEN DR",
            "city": "VAIL",
            "state": "CO",
            "postal_code": "816574395",
            "telephone_number": "970-476-7510",
            "fax_number": "970-476-7511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WACKER",
        "first_name": "MEGAN",
        "middle_name": "E",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-22",
        "last_updated": "2009-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "8955",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "CO8955",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEGAN",
            "last_name": "RIDDLE",
            "middle_name": "E",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• VVMC Diversified Services (Vail Health Clinic Vail East)
• VVMC Diversified Services (Surgical Associates)
• VVMC Diversified Services (Vail Health Clinic Vail Main)
• VVMC Diversified Services (Vail Health Clinic)
• VVMC Diversified Services Inc (Avanti Cardiology)
• Scott McLain Wacker, PT, DPT, CSCS
• Natalie Marie Wade
• Tiffany Larene Walker, RN
• Lori Walter, P.T.
• Marshall Tetsuo Walters, PA-C

• Physical Therapist in Vail, CO
• Providers in Vail, CO by specialty
• Physical Therapist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.