Active NPI
Melissa Wagner, PT, DPT
- Physical Therapist
- North Myrtle Beach, SC
National Provider Identifier
1861932790
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 10287
- Practice address
- 543 Highway 17 N
North Myrtle Beach, SC 29582-2903 - Phone
- (843) 390-8254
- NPI assigned
- Feb 25, 2017
- Last updated
- Nov 17, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 10287 | SC | Primary |
Addresses
Primary practice location
543 Highway 17 N
North Myrtle Beach, SC 29582-2903
Mailing address
247 Sienna Dr
Little River, SC 29566-7095
Phone (856) 308-6636
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10287 | SC | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orthosc, LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Orthopaedic Surgery Physician
- North Myrtle Beach, SC
- NPI 1568100691
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1487980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1763337600000",
"number": "1861932790",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "247 SIENNA DR",
"city": "LITTLE RIVER",
"state": "SC",
"postal_code": "295667095",
"telephone_number": "856-308-6636"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "543 HIGHWAY 17 N",
"city": "NORTH MYRTLE BEACH",
"state": "SC",
"postal_code": "295822903",
"telephone_number": "843-390-8254"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGNER",
"first_name": "MELISSA",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-02-25",
"last_updated": "2025-11-17",
"certification_date": "2025-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "SC",
"license": "10287",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Myrtle Beach, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 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.