Kylie Monet Wagner, OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

2826 Issued in NE

Practice address

17024 Morgan Ave
Gretna, NE 68028-3837

Phone

(402) 714-3575

NPI assigned

Nov 8, 2023

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

Medicare fee-for-service enrollment

Enrolled in NE

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Creighton University School of Medicine, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Propel Therapy, LLCGroup PAC ID 6709255011, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Propel Therapy, LLC

  • Rehabilitation Clinic/Center
  • Gretna, NE
  • NPI 1063178044
  Medicare reassignment Care Compare group NPD
• Lincoln Lymphedema and Occupational Therapy, LLC

  dba Llot

  • Physical Therapy Clinic/Center
  • Lincoln, NE
  • NPI 1215580048
  Medicare reassignment

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

{
    "created_epoch": "1699401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1740054055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1421 N 185TH ST",
            "city": "ELKHORN",
            "state": "NE",
            "postal_code": "680223835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17024 MORGAN AVE",
            "city": "GRETNA",
            "state": "NE",
            "postal_code": "680283837",
            "telephone_number": "402-714-3575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "KYLIE",
        "middle_name": "MONET",
        "name_prefix": "Dr.",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-08",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NE",
            "license": "2826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura-Catherine Vargo, MD
• Soudaphone Visonnavong
• Sandra Vodicka
• Katie Lora Vollmuth, M.D.
• Amberly Catherine Wagner-Connolly, DNP, MSN, RN
• Wal-Mart Stores Inc (Vision Center 30-4600)
• Walgreen Co (Walgreens #21446)
• Lindsay Wallman, M.S.
• Walmart Inc. (WalMart Pharmacy 10-4600)
• Sabrina Ward, OT

• Occupational Therapist in Gretna, NE
• Providers in Gretna, NE by specialty
• Occupational Therapist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2024; 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.