JAMES BLAKE WAGNER


Address: 1525 Country Club Rd, Sherwood, AR 72120-5076
Phone: 5019783135

JAMES BLAKE WAGNER (NPI# 1306804448) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1306804448
Entity Type Individual
Full Name JAMES BLAKE WAGNER
Credential P.T.
Practice Address 1525 Country Club Rd
Sherwood
AR 72120-5076
Practice Telephone 5019783135
Practice Fax Number 5019783138
Mailing Telephone 5019783135
Mailing Fax Number 5019783138
Enumeration Date 2006-05-01
Last Update Date 2014-03-11
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 2251S0007X Physical Therapist
Specialization: Sports
PT2565 AR Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Y 2251X0800X Physical Therapist
Specialization: Orthopedic
PT2565 AR Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
AR AR BLUE CROSS BLUE SHIELD 5W797C153 01

Other Providers JAMES WAGNER

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Office Location

Street Address 1525 COUNTRY CLUB RD
City SHERWOOD
State AR
Zip Code 72120-5076

Providers in the same location

NPI Name Taxonomy Address Enumeration
1598072480 Crystal Miller Goodman Physical Therapist 1525 Country Club Rd, Attn: Physical Therapy Department, Sherwood, AR 72120-5076 2010-09-13

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1215409818 Mary Kaye Hill Physical Therapist 6020 Warden Road, Sherwood, AR 72120 2018-12-20
1043714694 Healthcare Express, LLP Clinic/Center 1554 Country Club Road, Sherwood, AR 72120 2018-03-20
1265957690 Darryl Nathaniel Griffith Massage Therapist 9871 Brockington Road, Suite #1, Sherwood, AR 72120 2017-08-07
1669841011 Sarah Katherine Stephenson Pharmacist 102 Brockington Rd, Sherwood, AR 72120 2015-09-16
1063803328 The Legacy for Children and Families Counselor 190 Jan Drive, Suite #10, Sherwood, AR 72120 2015-02-09
1417297235 Andrew Hunter Beavers Counselor 37 Walton Rd., Sherwood, AR 72120 2013-02-15
1003156886 Infinity Hearing Center Inc. Hearing Aid Equipment 3115 E Kiehl Ave, Suite B, Sherwood, AR 72120 2013-02-15
1548543234 Lorrie Ann George Early Intervention Provider Agency 207 Fred Rains Drive, Sherwood, AR 72120 2011-09-20
1033411897 Tessa Monique Davis Occupational Therapist 21 Gunstock Lane, North Little Rock, AR 72120 2010-11-30
1720307903 Yousef Arfan Fahoum Psychologist 2215 Wildwood Ave Ste 200, Sherwood, AR 72120 2010-05-27
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Taxonomy Information

Taxonomy Code 2251X0800X
Grouping Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification Physical Therapist
Specialization Orthopedic

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1427445386 Brandon Rotap Physical Therapist 16770 Sw Edy Rd Ste 310, Sherwood, OR 97140 2015-04-17

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1861007841 Branden Shane Blume Physical Therapist 5300 S Southern Hills Ct # 200, Rogers, AR 72758-3500 2020-09-15
1154848133 Zach Brown Physical Therapist 4540 Jfk Blvd, North Little Rock, AR 72116-7309 2017-08-29
1275933772 Haley Mourot Physical Therapist 100 Walmart Dr Ste 5, Morrilton, AR 72110-4525 2014-09-03
1093153173 Christian Charles Robertozzi Physical Therapist 907 Se Village Loop Ste 5, Bentonville, AR 72712-2229 2013-06-11
1023320132 Rachael Lee Cummins Owens Physical Therapist 1065 Clayton St Ste 9, Conway, AR 72032-4335 2010-07-06
1275605727 Brian Paul Doorley Physical Therapist 16140 N Arrowhead Fountain Center Drive, Suite 105, Peoria, AR 85382 2006-11-13
1467554964 Bryan Nathaniel Grubbs Physical Therapist 1200 Old Warren Road, Monticello, AR 71655-3954 2006-09-04
1740243559 Anna Christine Turner-massanelli Physical Therapist 2113 Watts Road, Jordan Physical Therapy, Benton, AR 71901 2006-04-11
1124017058 Rowdy Kelly Physical Therapist 200 N College St, Mountain Home, AR 72653-3654 2005-10-13
1750865044 Ruth Ross Physical Therapist 1125 N College Ave, Fayetteville, AR 72703-1908 2018-09-21
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Competitor

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City SHERWOOD
Zip Code 72120

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Dataset Information

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.

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