Daniel Tadashi Wagner, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT-4925 Issued in HI

Practice address

1401 S Beretania St Ste 550
Honolulu, HI 96814-1880

Phone

(808) 381-8947

Fax

(808) 591-2245

NPI assigned

Nov 26, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1574726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574726400000",
    "number": "1679119549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 S BERETANIA ST STE 550",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968141880",
            "telephone_number": "808-381-8947",
            "fax_number": "808-591-2245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 S BERETANIA ST STE 550",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968141880",
            "telephone_number": "808-381-8947",
            "fax_number": "808-591-2245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "DANIEL",
        "middle_name": "TADASHI",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-11-26",
        "last_updated": "2019-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "PT-4925",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERSITY HEALTH ALLIANCE",
            "identifier": "53213",
            "state": "HI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "billing@jacorehab.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Honolulu",
            "address_1": "1401 S Beretania St Ste 550",
            "city": "Honolulu",
            "state": "HI",
            "country_code": "US",
            "postal_code": "968141880",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Joshua Peter Waddell, PTA
• Randall Scott Waddell
• Wade Takenishi D.D.S. L.L.C.
• Darlene Karen Wade, MSW
• Fabienne Marie Wade, PT
• Richard Chisholm Wagner, D.D.S
• Tasha N.S.W. Wagner, PHARMD
• Thomas Wahl, MS, ATC, CSCS
• Tricia M. Wahl, PA-C
• Mary A. Wahlman, RPH

• Physical Therapist in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Physical Therapist in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2019; 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.