Katherine Ann Wagner, MSOT

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

31006490A Issued in IN

Practice address

10294 E 96TH St
Fishers, IN 46037-9497

Phone

(317) 288-7572

NPI assigned

Nov 22, 2017

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Kids Innovative Developmental Services, Inc.

  • Speech-Language Pathologist
  • Fishers, IN
  • NPI 1669931960
  NPD

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

{
    "created_epoch": "1511308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766966400000",
    "number": "1831603158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5469 E 79TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462501705",
            "telephone_number": "812-607-0613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10294 E 96TH ST",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460379497",
            "telephone_number": "317-288-7572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "KATHERINE",
        "middle_name": "ANN",
        "credential": "MSOT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-22",
        "last_updated": "2025-12-29",
        "certification_date": "2025-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "IN",
            "license": "31006490A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daria Shelby Volker, PT, DPT
• Lorrie Beth Ippensen Vreeman, PT
• Linh T Vu, DC
• Urvy Vyas, DC
• Crystal Wade, LSW
• Kayla Lynn Wagner
• Emma Wagoner, RBT
• Wahl to Wahl Eyecare LLC
• Wal-Mart Stores East LP
• Wal-Mart Stores East LP

• Pediatric Occupational Therapist in Fishers, IN
• Providers in Fishers, IN by specialty
• Pediatric Occupational Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.