WAGNER PT & PERFORMANCE LLC (NPI# 1730678038) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730678038 |
| Entity Type | Organization |
| Organization Name | WAGNER PT & PERFORMANCE LLC |
| Practice Address |
290 Bedford St Lakeville MA 02347 |
| Mailing Address |
376 Laurel St Bridgewater MA 02324-2705 |
| Practice Telephone | 5089389787 |
| Mailing Telephone | 6262212628 |
| Enumeration Date | 2018-05-02 |
| Last Update Date | 2018-07-12 |
| Authorized Official Name | ZACHARY R WAGNER (OWNER) |
| Authorized Official Telephone | 6262212628 |
| Authorized Official Credential | PT, DPT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
1346-AH-PF | MA | Ambulatory Health Care Facilities |
| Street Address |
290 BEDFORD ST |
| City | LAKEVILLE |
| State | MA |
| Zip Code | 02347 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902424302 | Sherry Ann Szczepkowski-demoura | Nurse Practitioner | 82 Freetown Street, Lakeville, MA 02347 | 2020-07-12 |
| 1275960478 | Scott Michael Jarvis | Social Worker | 5 Bells Brook Rd, Lakeville, MA 02347 | 2013-10-02 |
| 1508034240 | Nelia M. Rodelle | Technician/Technologist | 47 Fuller Shores Road, Lakeville, MA 02347 | 2008-02-15 |
| 1497951594 | Lakeville Physical Therapy Inc | Physical Therapist | 155 Millennium Cir, Suite 114, Lakeville, MA 02347 | 2007-06-25 |
| 1609901875 | Lift & Care Systems, Inc. | Durable Medical Equipment & Medical Supplies | 7 Precinct Street, Lakeville, MA 02347 | 2007-02-21 |
| 1154479582 | Stephen Givinal Gouveia | Physical Therapist | 155 Millenium Dr, Lakeville Physical Therapy Inc Suite 114, Lakeville, MA 02347 | 2007-01-08 |
| 1992802615 | George Palaiologos | Chiropractor | 66 Main Street, Lakeville, MA 02347 | 2006-09-17 |
| 1326055419 | Cameron Luree Marzelli | Psychologist | 104 Charles Eldredge Drive, Lakeville, MA 02347 | 2006-08-02 |
| 1740295617 | Paige A Leavitt-halsall | Registered Nurse | 104 Charles Eldridge Drive, Tranquil Mind & Wellness Inc, Lakeville, MA 02347 | 2006-07-29 |
| 1649284464 | Debra Ann Bulger | Social Worker | 104 Charles Eldridge Dr, Lakeville, MA 02347 | 2006-07-28 |
| Find all providers in zip 02347 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649502881 | Synergy Physical Therapy, Inc | Clinic/Center | 17760 Layton Path, Lakeville, MN 55044-5214 | 2010-02-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013518448 | Shira Lauren Dragun | Clinic/Center | 63 1/2 Jefferson Ave, Salem, MA 01970-2975 | 2020-11-03 |
| 1518564566 | Ann Pappas Physical Therapy | Clinic/Center | 470 Washington St Ste 31, Norwood, MA 02062-2343 | 2020-10-02 |
| 1538786272 | Neurologic Optimal Wellness Physical Therapy LLC | Clinic/Center | 180 King St, Springfield, MA 01109-4316 | 2020-06-29 |
| 1689297525 | Full Spectrum Physical Therapy and Performance, LLC | Clinic/Center | 17 Cannongate Rd Apt 83, Tyngsboro, MA 01879-1413 | 2020-05-27 |
| 1992328421 | Adam Auto Accident Physio Doctor,inc | Clinic/Center | 1011 Beacon St Ste 1, Brookline, MA 02446-5696 | 2020-05-19 |
| 1952938839 | Jessica Moy Wellness LLC | Clinic/Center | 255 Massachusetts Ave Apt 204, Boston, MA 02115-3511 | 2020-03-23 |
| 1598390940 | The Method Performance and Physical Therapy LLC | Clinic/Center | 378 North St Apt 2, Boston, MA 02113-2143 | 2020-03-05 |
| 1104458785 | Olender Physical Therapy, LLC | Clinic/Center | 316 Washington St Ste 1, Wellesley, MA 02481-4959 | 2020-02-11 |
| 1851930028 | Core Physical Therapy & Performance, LLC | Clinic/Center | 11 Randolph Rd, Randolph, MA 02368-4321 | 2020-01-05 |
| 1316585482 | Healthworks Med Group of Massachusetts P C | Clinic/Center | 157 Berkeley St, Boston, MA 02116-5108 | 2019-12-19 |
| Find all providers with the same taxonomy | ||||
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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.