KERRY GRIMES WAGNER (NPI# 1194049056) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194049056 |
| Entity Type | Individual |
| Full Name | KERRY GRIMES WAGNER |
| Credential | MPT |
| Practice Address |
1120 Via Callejon Ste B San Clemente CA 92673-6264 |
| Practice Telephone | 9494811095 |
| Mailing Telephone | 9494811095 |
| Enumeration Date | 2010-03-22 |
| Last Update Date | 2011-12-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225100000X | Physical Therapist | PT 24160 | CA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
1120 VIA CALLEJON STE B |
| City | SAN CLEMENTE |
| State | CA |
| Zip Code | 92673-6264 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740301647 | Betsy Ann Aasland | Occupational Therapist | 1120 Via Callejon Ste B, San Clemente, CA 92673-6264 | 2007-04-02 |
| 1720416522 | Ashley Mancino | Specialist/Technologist | 1120 Via Callejon Ste B, San Clemente, CA 92673-6264 | 2013-10-15 |
| 1104251495 | Kendall Scott | Speech-Language Pathologist | 1120 Via Callejon Ste B, San Clemente, CA 92673-6264 | 2013-09-05 |
| 1275814378 | Amanda Colleen Fink | Specialist | 1120 Via Callejon Ste B, San Clemente, CA 92673-6264 | 2011-09-01 |
| 1730498429 | Tala Brinderson | Occupational Therapist | 1120 Via Callejon Ste B, San Clemente, CA 92673-6264 | 2010-09-29 |
| 1629394861 | Kestrel Suzanne Wood Hutchison | Occupational Therapy Assistant | 1120 Via Callejon Ste B, San Clemente, CA 92673-6264 | 2010-04-13 |
| 1639494701 | Elizabeth Hayter | Physical Therapist | 1120 Via Callejon Ste B, San Clemente, CA 92673-6264 | 2010-04-01 |
| 1831413699 | Stacy Rose Goldfield | Specialist/Technologist | 1120 Via Callejon Ste B, San Clemente, CA 92673-6264 | 2010-03-23 |
| 1437473352 | Caitlin Spates | Occupational Therapy Assistant | 1120 Via Callejon Ste B, San Clemente, CA 92673-6264 | 2010-03-22 |
| 1285958132 | Katie Marie Reno | Specialist/Technologist | 1120 Via Callejon Ste B, San Clemente, CA 92673-6264 | 2010-03-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497246474 | Cynthia Hull Warren | Nutritionist | 2027 Via Concha, San Clemente, CA 92673 | 2018-05-24 |
| 1063942688 | Trinh T Tran | Pharmacist | 638 Camino De Los Mares #d5, San Clemente, CA 92673 | 2017-06-15 |
| 1427421791 | Jessica A Currens | Nurse Practitioner | 1001 Avenida Pico Ste C517, San Clemente, CA 92673 | 2015-11-08 |
| 1184010647 | Garrett Bryon Rubio | Student in an Organized Health Care Education/Training Program | 905 Calle Amanecer Ste. 265, San Clemente, CA 92673 | 2015-04-11 |
| 1255733853 | Body Mind Spirit Iop Inc | Psychologist | 665 Camino De Los Mares Ste 104, San Clemente, CA 92673 | 2014-09-25 |
| 1548677438 | Jessica Ann Riley | Dermatology | 1300 Avenida Vista Hermosa Ste 150, San Clemente, CA 92673 | 2014-07-13 |
| 1427398718 | Veena Menda | Specialist | 2232 Calle Opalo, San Clemente, CA 92673 | 2013-02-22 |
| 1124383781 | Alexandra Rose Corporation | Substance Abuse Rehabilitation Facility | 4009 Calle Abril, San Clemente, CA 92673 | 2012-07-10 |
| 1457612574 | Noelle J Deckman | Psychologist | 629 Camino De Los Mares Ste 207a, San Clemente, CA 92673 | 2012-06-05 |
| 1851686471 | Meighan Bartholomew Merono | Pharmacist | 990 Avenida Vista Hermosa, San Clemente, CA 92673 | 2011-06-10 |
| Find all providers in zip 92673 | ||||
| Taxonomy Code | 225100000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT’s assess joint motion, muscle strength and endurance, function of heart and lungs, and performance of activities required in daily living, among other responsibilities. Treatment includes therapeutic exercises, cardiovascular endurance training, and training in activities of daily living. (2) A physical therapist is a person qualified by an accredited program in physical therapy, licensed by the state, and practicing within the scope of that license. Physical therapists treat disease, injury, or loss of a bodily part by physical means, such as the application of light, heat, cold, water, electricity, massage and exercise. They develop treatment plans based upon each patient’s strengths, weaknesses, range of motion and ability to function. (3) A health professional who specializes in physical therapy- the health care field concerned primarily with the treatment of disorders with physical agents and methods, such as massage, manipulation, therapeutic exercises, cold, heat (including short-wave, microwave, and ultrasonic diathermy), hydrotherapy, electric stimulation and light to assist in rehabilitating patients and in restoring normal function after an illness or injury. |
| Notes: Source: (1) APTA Guidelines for Physical Therapy Claims Review, American Physical Therapy Association. (3) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 612 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730503772 | Mary Elizabeth Montagna | Physical Therapist | 163 W Avenida De Los Lobos Marinos, San Clemente, CA 92672-4359 | 2014-02-11 |
| 1235576133 | Ashley Heller | Physical Therapist | 235 Via San Andreas, San Clemente, CA 92672-3712 | 2013-05-31 |
| 1427324508 | Constance Anne Moisan | Physical Therapist | 302 N El Camino Real Ste 106, San Clemente, CA 92672-4776 | 2012-03-22 |
| 1336429554 | Marina Asil | Physical Therapist | 21 Via Soria, San Clemente, CA 92673-7015 | 2011-08-18 |
| 1831498468 | Jeffrey Keith Silverberg | Physical Therapist | 1603 Via Calendula, San Clemente, CA 92673-3734 | 2011-03-22 |
| 1689978876 | Kira Milner | Physical Therapist | 1632 Vista Luna, San Clemente, CA 92673-3660 | 2011-01-02 |
| 1568777050 | Helen Tache Kabbani | Physical Therapist | 1327 Calle Avanzado Ste B, San Clemente, CA 92673-6351 | 2010-08-10 |
| 1427297803 | Arthur Lupsha | Physical Therapist | 222 Avenida Lobeiro, Unit A, San Clemente, CA 92672-7406 | 2009-02-09 |
| 1760658074 | Beach Kids Therapy Center, Inc. | Physical Therapist | 970 Calle Amanecer Ste A, San Clemente, CA 92673-6250 | 2008-05-06 |
| 1437320207 | Julie Kathleen Tobin | Physical Therapist | 25 S Montilla, San Clemente, CA 92672-6000 | 2008-03-19 |
| Find all providers in SAN CLEMENTE | ||||
| City | SAN CLEMENTE |
| Zip Code | 92673 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.