Denise K Wagner, D.P.T

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT013472L Issued in PA

Practice address

1634 W Thistle Dr
Wyomissing, PA 19610-1273

Phone

(610) 301-3259

NPI assigned

Dec 26, 2006

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Aquabilities, Inc.

  • Physical Therapy Clinic/Center
  • Birdsboro, PA
  • NPI 1851456123

  Physical Therapist

  NPD (past)
• Easter Seals Eastern Pennsylvania

  • Developmentally Disabled Services Day Training Agency
  • Allentown, PA
  • NPI 1982743951

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467072000000",
    "number": "1871658385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1634 W THISTLE DR",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196101273",
            "telephone_number": "610-301-3259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1634 W THISTLE DR",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196101273",
            "telephone_number": "610-301-3259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "DENISE",
        "middle_name": "K",
        "credential": "D.P.T",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-26",
        "last_updated": "2016-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT013472L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "WA917843",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "02200101",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Son Vu, MD
• Son Van Vu, O.D.
• Shivani Vyas, D.O.
• Jerome Wachter
• Beth Ann Wagner, CRNP
• Jaimi Wagner
• Samantha Wagner, LAPC
• Yadja Wagner
• Elizabeth Ann Waholek, M.A., LBSC
• Wal-Mart Stores East LP

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2016; 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.