Diana Teresa Wagner, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT008968L Issued in PA

Practice address

30 Old Schuylkill Rd
Pottstown, PA 19465-7971

Phone

(610) 705-3737

Fax

(484) 624-5985

NPI assigned

Aug 8, 2013

Last updated

Aug 8, 2013By the provider in NPPES

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 PA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1992

Medicare assignment

May accept Medicare assignment

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.

• Healing Energies Chiropractic Center

  • Chiropractor
  • Royersford, PA
  • NPI 1316361090
  Medicare reassignment NPD

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

{
    "created_epoch": "1375920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375920000000",
    "number": "1750713020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 OLD SCHUYLKILL RD",
            "city": "POTTSTOWN",
            "state": "PA",
            "postal_code": "194657971",
            "telephone_number": "610-705-3737",
            "fax_number": "484-624-5985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 OLD SCHUYLKILL RD",
            "city": "POTTSTOWN",
            "state": "PA",
            "postal_code": "194657971",
            "telephone_number": "610-705-3737",
            "fax_number": "484-624-5985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "DIANA",
        "middle_name": "TERESA",
        "name_prefix": "Mrs.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-08",
        "last_updated": "2013-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT008968L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Syed H Viqar, MD
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• Kayla Voegtle
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-2263)
• Wal-Mart Stores East, LP. (Walmart pharmacy 10-3164)
• Shelby Jae Walker, PA-C
• Ashley Wallace
• Isabel Louise Wallace

• Physical Therapist in Pottstown, PA
• Providers in Pottstown, PA by specialty
• Physical Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2013; 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.