Jeannie Chien Wagner, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501004592 Issued in MI

Practice address

1055 W Baraga Ave
Suite D
Marquette, MI 49855-4068

Phone

(906) 226-0143

Fax

(906) 226-0152

NPI assigned

Mar 30, 2008

Last updated

Mar 30, 2008By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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)

Enrolled

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

{
    "created_epoch": "1206835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206835200000",
    "number": "1902078983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 W BARAGA AVE",
            "address_2": "SUITE D",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498554068",
            "telephone_number": "906-226-0143",
            "fax_number": "906-226-0152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 W BARAGA AVE",
            "address_2": "SUITE D",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498554068",
            "telephone_number": "906-226-0143",
            "fax_number": "906-226-0152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "JEANNIE",
        "middle_name": "CHIEN",
        "name_prefix": "Ms.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-30",
        "last_updated": "2008-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501004592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Marquette, MI
• Providers in Marquette, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2008; 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.