MR. JUSTIN ROMAN WAGNER (NPI# 1669451472) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669451472 |
| Entity Type | Individual |
| Full Name | MR. JUSTIN ROMAN WAGNER |
| Credential | PT |
| Practice Address |
Rec Center Physical Therapy 400 Collins Rd Ne 154-100 Cedar Rapids IA 52498-0001 |
| Practice Telephone | 3192958899 |
| Practice Fax Number | 3192958833 |
| Mailing Telephone | 3192958899 |
| Mailing Fax Number | 3192958833 |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2013-10-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 03670 | IA | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | WELLMARK PROVIDER NUMBER | 38070 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871818484 | Justin Philip Wagner | Surgery | 200 Ucla Medical Plz # 265, Los Angeles, CA 90095-8344 | 2010-04-07 |
| 1871121798 | Justin John Wagner | Student in an Organized Health Care Education/Training Program | 2601 Ocean Pkwy, Brooklyn, NY 11235-7745 | 2020-03-27 |
| 1245647700 | Justin Wagner | Pharmacist | 1650 W Maloney Ave, Gallup, NM 87301-3305 | 2014-07-16 |
| 1356608004 | Justin Timothy Wagner | Radiology | 804 Service Rd, Room D100, East Lansing, MI 48824-7021 | 2012-04-19 |
| 1306051362 | Justin B Wagner | Emergency Medicine | 1650 Creekside Dr, Folsom, CA 95630-3400 | 2007-05-13 |
| Street Address |
REC CENTER PHYSICAL THERAPY 400 COLLINS RD NE 154-100 |
| City | CEDAR RAPIDS |
| State | IA |
| Zip Code | 52498-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083634539 | Kristen Kae Dupont | Physical Therapist | 400 Collins Rd Ne Bldg 154-100, Cedar Rapids, IA 52498-0001 | 2006-07-20 |
| 1366500506 | Dana L Lamm | Physical Therapist | 400 Collins Rd Ne, Cedar Rapids, IA 52498-0001 | 2006-12-04 |
| 1760540926 | Match Play Tennis Centers, Inc. | Clinic/Center | 400 Collins Rd Ne, Bldg 154-100, Cedar Rapids, IA 52498-0001 | 2006-12-04 |
| 1285657932 | Jane Marie Thurm | Physical Therapist | 400 Collins Rd Ne Bldg 154-100, Cedar Rapids, IA 52498-0001 | 2006-07-25 |
| 1972524114 | Christopher Scott Brink | Physical Therapist | 400 Collins Rd Ne Bldg 154-100, Cedar Rapids, IA 52498-0001 | 2006-07-22 |
| 1811453251 | Kristopher Krohn | Physical Therapist | 400 Collins Rd Ne # Ms 154100, Cedar Rapids, IA 52498-0505 | 2019-02-11 |
| 1588758486 | Jill Kilkenny | Physical Therapist | 400 Collins Rd Ne # 154-100, Cedar Rapids, IA 52498-0505 | 2006-10-03 |
| 1558466185 | Ashlee Erin Fandel | Physical Therapist | 400 Collins Rd Ne, Cedar Rapids, IA 52498-0505 | 2006-09-14 |
| 1982252656 | Anya Christine Polehna | Physical Medicine & Rehabilitation | 400 Collins Rd Ne # Ms 154100, Cedar Rapids, IA 52498-0505 | 2019-08-27 |
| 1710251285 | Tony Yelden | Specialist/Technologist | 400 Collins Rd Ne # 154-100, Cedar Rapids, IA 52498-0505 | 2012-03-01 |
| Find all providers in zip 52498 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568423192 | John Hugh Wollner | Specialist | 716 5th Ave Se, Cedar Rapids, IA 52401-1916 | 2006-03-31 |
| 1265491849 | Donald Bruce Johnson | Specialist | 1815 1st Ave Se, Suite 200, Cedar Rapids, IA 52402-5417 | 2006-03-21 |
| 1407483589 | Lynn Hennings | Specialist | 921 Blairs Ferry Rd Ne Ste 110, Cedar Rapids, IA 52402-1262 | 2020-03-26 |
| 1104296995 | New Beginnings | Specialist | 1073 Rockford Rd Sw, Cedar Rapids, IA 52404-1868 | 2015-10-06 |
| 1134366909 | Bassel Eid | Specialist | 1201 3rd Ave Se, Cedar Rapids, IA 52403-4009 | 2009-01-15 |
| 1114119229 | Lauren Elizabeth Doughty-mcdonald | Specialist | 1815 1st Ave Se, Suite 200, Cedar Rapids, IA 52402-5417 | 2007-08-13 |
| 1962610725 | Dermatology Clinic of Iowa PC | Specialist | 1815 1st Ave Se, Suite 200, Cedar Rapids, IA 52402-5434 | 2007-05-17 |
| 1356387260 | Samuel K Wood | Specialist | 701 10th St Se, Cedar Rapids, IA 52403-1251 | 2006-06-20 |
| 1649219346 | Leslie Kramer | Specialist | 411 10th St Se, Cedar Rapids, IA 52403-2442 | 2006-06-06 |
| 1659344612 | Shaun Mccarthy | Specialist | 1220 1st Ave Ne, Cedar Rapids, IA 52402-5008 | 2006-02-09 |
| Find all providers in CEDAR RAPIDS | ||||
| City | CEDAR RAPIDS |
| Zip Code | 52498 |
Please comment or provide details below to improve the information on MR. JUSTIN ROMAN WAGNER.
| 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.