Richard Earl Wagner, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PTL.0013597 Issued in CO

Practice address

200 Quebec St BLDG 600
Ste 215
Denver, CO 80230-7144

Phone

(303) 341-0369

Fax

(303) 341-0866

NPI assigned

May 21, 2015

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 CO

Enrollment records 1

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 and National Provider Directory roles.

• Colorado Athletic Conditioning Clinic Lowry Professional LLC

  • Physical Therapist
  • Parker, CO
  • NPI 1245281955
  Medicare reassignment NPD
• In Motion Hand Therapy Inc

  • Rehabilitation Clinic/Center
  • Montrose, CO
  • NPI 1407804065

  Physical Therapist

  NPD
• Montrose Memorial Hospital, Inc

  • Diagnostic Radiology Physician
  • Montrose, CO
  • NPI 1437997947
  NPD (past)

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

{
    "created_epoch": "1432166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449014400000",
    "number": "1770962805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 QUEBEC ST BLDG 600",
            "address_2": "STE 215",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802307144",
            "telephone_number": "303-341-0369",
            "fax_number": "303-341-0866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 QUEBEC ST BLDG 600",
            "address_2": "STE 215",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802307144",
            "telephone_number": "303-341-0369",
            "fax_number": "303-341-0866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "RICHARD",
        "middle_name": "EARL",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-21",
        "last_updated": "2015-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PTL.0013597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kay E. Wagner, M.D.
• Leland Dean Wagner, LPC
• Madeleine Wagner
• Neal Wagner
• Penelope Andrea Wagner, NP
• Rylee Wagner, MD
• Theresa Wagner, PHARM.D.
• Tyler Wagner
• Katrina Wagoner-Hursh, MD
• Dennis Eric Waguespack, D.D.S., M.S.

• Physical Therapist in Denver, CO
• Providers in Denver, CO by specialty
• Physical Therapist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.