KELLY LYNN WAGNITZ (NPI# 1528230497) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528230497 |
| Entity Type | Individual |
| Full Name | KELLY LYNN WAGNITZ |
| Credential | PTA |
| Practice Address |
744 S Webster Ave Green Bay WI 54301-3505 |
| Practice Telephone | 9204227822 |
| Mailing Telephone | 9203360890 |
| Enumeration Date | 2008-03-31 |
| Last Update Date | 2008-03-31 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225200000X | Physical Therapy Assistant | 721-091 | WI | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 36118700 | 05 |
| Street Address |
744 S WEBSTER AVE |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54301-3505 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851398283 | Sampoornima Setty | Internal Medicine | 744 S Webster Ave, Green Bay, WI 54301-3505 | 2005-06-30 |
| 1447858857 | Caycie N Bray | Physical Therapist | 744 S Webster Ave, Green Bay, WI 54301-3505 | 2020-10-16 |
| 1326645029 | Nikki Lee Leow | Registered Nurse | 744 S Webster Ave, Green Bay, WI 54301-3505 | 2020-10-06 |
| 1033726914 | Patricia M Slempkes | Occupational Therapist | 744 S Webster Ave, Green Bay, WI 54301-3505 | 2020-09-25 |
| 1255941746 | Cassandra Toellner | Anesthesiologist Assistant | 744 S Webster Ave, Green Bay, WI 54301-3505 | 2020-08-09 |
| 1376151951 | Dayna Elizabeth Schneider | Speech-Language Pathologist | 744 S Webster Ave, Green Bay, WI 54301-3505 | 2020-07-20 |
| 1164045092 | Robyn W Lauritsen | Registered Nurse | 744 S Webster Ave, Green Bay, WI 54301-3505 | 2020-05-27 |
| 1831711860 | Ashley Elizabeth Mijal | Nurse Practitioner | 744 S Webster Ave, Green Bay, WI 54301-3505 | 2020-05-13 |
| 1336760883 | Veronica B Hoppe | Pharmacist | 744 S Webster Ave, Green Bay, WI 54301-3505 | 2020-05-06 |
| 1386264521 | Brian Joseph Eggener | Radiology | 744 S Webster Ave, Green Bay, WI 54301-3505 | 2020-04-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386102465 | Parc Village Dental, LLC | Dentist | 2805 Libal Street, Suite A, Green Bay, WI 54301 | 2019-03-07 |
| 1598229478 | Shaina Marie Conner | Registered Nurse | 835 S Vanburen St, Green Bay, WI 54301 | 2019-01-25 |
| 1093298960 | Brown County | Case Management | 111 N. Jefferson Street, Green Bay, WI 54301 | 2018-09-07 |
| 1639609928 | Frontline Healthcare LLC | Specialist/Technologist, Other | 2221 S. Webster Ave. Suite 270, Greenbay, WI 54301 | 2017-06-19 |
| 1992242606 | Charmaine Rimple | Counselor | 526 South Monroe Avenue, Green Bay, WI 54301 | 2017-01-20 |
| 1962944819 | Rebecca Lucille Reinbold | Registered Nurse | 917 Catherine Street, Green Bay, WI 54301 | 2016-11-09 |
| 1730635061 | Melissa Kristof | Specialist/Technologist, Other | 1821 Sounth Webster Ave., Green Bay, WI 54301 | 2016-08-28 |
| 1255709747 | Vivian Sweetheart Bishop-cook | Counselor | 2920 South Webster Ave, Green Bay, WI 54301 | 2015-09-14 |
| 1881079960 | Chelsi S Weber | Registered Nurse | 2300 Riverside Dr., Ste 204, Green Bay, WI 54301 | 2015-07-30 |
| 1962816371 | Joelle M Hesse | Counselor | 630 Cherry St., Green Bay, WI 54301 | 2014-06-13 |
| Find all providers in zip 54301 | ||||
| Taxonomy Code | 225200000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapy Assistant |
| (1)Physical therapist assistants are skilled health care providers who are graduates of a physical therapist assistant associate degree program accredited by an agency recognized by the Secretary of the U.S. Department of Education or Council on Postsecondary Accreditation, who assists the physical therapist in providing physical therapy. The supervising physical therapist is directly responsible for the actions of the physical therapist assistant. The PTA performs physical therapy procedures and related tasks that have been selected and delegated by the supervising physical therapist. Duties of the PTA include assisting the physical therapist in implementing treatment programs, training patients in exercised and activities of daily living, conducting treatments, and reporting to the physical therapist on the patient’s responses. In addition to direct patient care, the PTA may also perform such functions as patient transport, and clinic or equipment preparation and maintenance. Currently more than half of all states require PTAs to be licensed, registered or certified. (2) An individual who works under the supervision of a physical therapist to assist him or her in providing physical therapy services. A physical therapy assistant may, for instance, help patients follow an appropriate exercise program that will increase their strength, endurance, coordination, and range of motion and train patients to perform activities of daily life. |
| Notes: Source: (1) American Physical Therapy Association, P.O. Box 37257, Washington, D.C. 20013. (2) 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 |
|---|---|---|---|---|
| 1194265033 | Bryan Gilow | Physical Therapy Assistant | 2617 Zak Ln, Green Bay, WI 54304-1630 | 2017-02-25 |
| 1619365681 | Miranda Marie Hermes | Physical Therapy Assistant | 2305 San Luis Place, Green Bay, WI 54304-5211 | 2014-12-29 |
| 1679904684 | Nicolas Alan Riggs | Physical Therapy Assistant | 2869 Viking Dr, #165, Green Bay, WI 54304-5990 | 2013-12-02 |
| 1770912024 | Jesse Matthew Fitzgerald | Physical Therapy Assistant | 228 Newhall St, Green Bay, WI 54302-1708 | 2013-11-07 |
| 1932542545 | Amy Beth Smedema | Physical Therapy Assistant | 632 S Jackson St, Green Bay, WI 54301-3512 | 2013-04-12 |
| 1417211798 | Audrey Mary Waldschmidt | Physical Therapy Assistant | 1229 S Jackson St, Green Bay, WI 54301-3037 | 2012-07-01 |
| 1326346636 | Melissa Ann Mooren | Physical Therapy Assistant | 2768 Friendly Cir, Green Bay, WI 54313-9533 | 2011-03-10 |
| 1114241288 | Katelyn Mae Servi | Physical Therapy Assistant | 2656 Finger Rd, Green Bay, WI 54302-4821 | 2010-03-18 |
| 1417187154 | Michelle Berkovitz | Physical Therapy Assistant | 2981 Fleetwood Dr, Green Bay, WI 54313-1379 | 2009-07-15 |
| 1508019217 | Brenda Lee Peebles | Physical Therapy Assistant | 546 Gwynn St, Green Bay, WI 54301-1079 | 2008-10-25 |
| Find all providers in GREEN BAY | ||||
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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.