Austin Wagner, PT, DPT, ACSM-EP

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

3000 S State Road 135
Greenwood, IN 46143-9825

Phone

(317) 497-6000

Fax

(317) 497-2514

NPI assigned

Aug 16, 2021

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

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

CHN JMH Ventures LLCGroup PAC ID 3870728512, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• CHN JMH Ventures LLC

  • Physical Therapist
  • Greenwood, IN
  • NPI 1902242084
  Medicare reassignment Care Compare group NPD
• CHN JMH Ventures LLC

  • Radiology Clinic/Center
  • Greenwood, IN
  • NPI 1134564016
  NPD

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

{
    "created_epoch": "1629072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629072000000",
    "number": "1689349201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "238 S RURAL ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462014262",
            "telephone_number": "317-650-9001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 S STATE ROAD 135",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461439825",
            "telephone_number": "317-497-6000",
            "fax_number": "317-497-2514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "AUSTIN",
        "credential": "PT, DPT, ACSM-EP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-16",
        "last_updated": "2021-08-16",
        "certification_date": "2021-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dipti S Vyas, DO
• Sanjay Vyas, DO
• Morgan Wade
• Patricia Ann Wade, PHD, EDS, IN LICENSE
• Jennifer M. Wagar, MS, PT
• Wal-Mart Stores East LP
• Wal-Mart Stores East LP
• Wal-Mart Stores East, LP
• Rhyan Olivia Walden
• Walgreen Co

• 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 Aug 16, 2021; 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.