Charles V Wabbersen, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1157230 Issued in TX

Practice address

2851 Matlock Rd
#442
Mansfield, TX 76063-5037

Phone

(817) 473-6246

Fax

(817) 473-2014

NPI assigned

Jan 17, 2007

Last updated

Nov 16, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Green Oaks Physical Therapy Limited PartnershipGroup PAC ID 4688582141, 208 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Green Oaks Physical Therapy Limited Partnership

  • Rehabilitation Clinic/Center
  • Waxahachie, TX
  • NPI 1467881565
  Medicare reassignment Care Compare group
• Green Oaks Physical Therapy Limited Partnership

  • Physical Therapist
  • Midlothian, TX
  • NPI 1053993048
  NPD

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195171200000",
    "number": "1689726176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2851 MATLOCK RD",
            "address_2": "#442",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760635037",
            "telephone_number": "817-473-6246",
            "fax_number": "817-473-2014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2851 MATLOCK RD",
            "address_2": "#442",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760635037",
            "telephone_number": "817-473-6246",
            "fax_number": "817-473-2014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WABBERSEN",
        "first_name": "CHARLES",
        "middle_name": "V",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-17",
        "last_updated": "2007-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1157230",
            "primary": true
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "TX",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Virt Derm, PLLC (Virtual Dermatology)
• Visionworks, Inc. (Visionworks)
• Lien Vo, OTR
• Vohra Post Acute Care Physicians of Texas, PLLC
• Jessica Vu
• Antwain Wade
• Sydney Waggoner
• Randall Wagman, M.D.
• Jeffrey Lynn Wagnon, D.C.
• Paidamoyo Yvonne Wagoneka

• Physical Therapist in Mansfield, TX
• Providers in Mansfield, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2007; 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.