MR. KEVIN MATTHEW WAGNER (NPI# 1295735926) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295735926 |
| Entity Type | Individual |
| Full Name | MR. KEVIN MATTHEW WAGNER |
| Credential | MD PT CERT MDT |
| Practice Address |
11903 Saint Charles Rock Rd Bridgeton MO 63044-2623 |
| Mailing Address |
Back Pain Institute of St. Louis LLC 11903 St. Charles Rock Rd. Bridgeton MO 63044 |
| Practice Telephone | 3147700900 |
| Practice Fax Number | 3147701673 |
| Mailing Telephone | 3147700900 |
| Mailing Fax Number | 3147398569 |
| Enumeration Date | 2005-07-22 |
| Last Update Date | 2010-04-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225100000X | Physical Therapist | 115026 | MO | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093224933 | Kevin Wagner | Contractor | 19644 Hull Prairie Rd, Bowling Green, OH 43402 | 2017-09-22 |
| 1386038636 | Kevin Wagner | Hearing Instrument Specialist | 3534 Clark Rd, #132, Sarasota, FL 34231-8408 | 2015-03-25 |
| 1821620451 | Kevin Wagner | Nurse Practitioner | 1001 Blythe Blvd, Ste 300- Adult Cardiology, Charlotte, NC 28203-5866 | 2020-02-11 |
| 1306006978 | Kevin Wagner | Physical Therapist | 3283 Motor Ave, Los Angeles, CA 90034-3709 | 2008-06-16 |
| 1215139894 | Kevin Dale Wagner | Social Worker | 1500 N Westwood Blvd, Poplar Bluff, MO 63901-3318 | 2007-06-05 |
| Street Address |
11903 SAINT CHARLES ROCK RD |
| City | BRIDGETON |
| State | MO |
| Zip Code | 63044-2623 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114301678 | Md Health and Wellness LLC | Chiropractor | 11903 Saint Charles Rock Rd, Bridgeton, MO 63044-2623 | 2015-07-15 |
| 1497090567 | Tiffany Mitchell | Technician, Other | 11903 Saint Charles Rock Rd, Bridgeton, MO 63044-2623 | 2012-11-30 |
| 1548514797 | Tyronda Thomas | Technician, Other | 11903 Saint Charles Rock Rd, Bridgeton, MO 63044-2623 | 2012-11-08 |
| 1831443084 | Angela Perry | Technician, Other | 11903 Saint Charles Rock Rd, Bridgeton, MO 63044-2623 | 2012-11-08 |
| 1770715906 | Advantage Pain Management Inc | Chiropractor | 11903 Saint Charles Rock Rd, Bridgeton, MO 63044-2623 | 2009-08-21 |
| 1184772816 | George V Andreoff | Internal Medicine | 11903 Saint Charles Rock Rd, Bridgeton, MO 63044-2623 | 2007-01-08 |
| 1477659217 | Back Pain Institute of St. Louis, LLC | Chiropractor | 11903 Saint Charles Rock Rd, Bridgeton, MO 63044-2623 | 2006-09-16 |
| 1902840218 | Flordeliz R Ross | Specialist | 11903 Saint Charles Rock Rd, Bridgeton, MO 63044-2623 | 2006-06-16 |
| 1871594564 | Arturo J Pamaong | Registered Nurse | 11903 Saint Charles Rock Rd, Back Pain Institute of St. Louis LLC, Bridgeton, MO 63044-2623 | 2005-08-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073150017 | Zoe Marie Wadsworth | Nurse Practitioner | 12255 Depaul Dr Suite 300, Bridgeton, MO 63044 | 2019-12-10 |
| 1609412451 | Beyond Better, Best Home Health Care Services, Limited Liability Corpo | In Home Supportive Care | 3430 Mckelvey Road Ste B, Bridgeton, MO 63044 | 2019-11-26 |
| 1275189078 | Delicate Angels Home Health LLC | Home Health | 11726 St. Charles Rock Road Suite G, Bridgeton, MO 63044 | 2019-08-16 |
| 1588210082 | Nicholas Huber | Physical Therapist | 12349 Depaul Dr., Ste. 110, Bridgeton, MO 63044 | 2019-08-12 |
| 1124688858 | Michelle Bassett | Registered Nurse | 11520 St. Charles Rock Rd., Suite 106, Bridgeton, MO 63044 | 2019-06-14 |
| 1336703883 | Elena A Barrow | Nurse Practitioner | 12255 Depaul Dr, Suite 260, Bridgeton, MO 63044 | 2019-04-30 |
| 1487123105 | Laura N Steiner | Registered Nurse | Gateway Pediatrics, Ltd, 12255 Depaul Drive, Suite 460 North Medical Building, Bridgeton, MO 63044 | 2018-11-26 |
| 1205310950 | Danielle Mathis | Nurse Practitioner | 3440 Depaul Lane Suite 201, Bridgeton, MO 63044 | 2018-09-19 |
| 1588163570 | Thoughts Out Loud Counseling, LLC | Social Worker | 11520 St. Charles Rock Road Suite 101, Bridgeton, MO 63044 | 2018-02-06 |
| 1912411430 | Breanna Victoria Hayes | Counselor | 3165 Mckevley Road, Suite 200, Bridgeton, MO 63044 | 2017-11-20 |
| Find all providers in zip 63044 | ||||
| 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 |
|---|---|---|---|---|
| 1588210082 | Nicholas Huber | Physical Therapist | 12349 Depaul Dr., Ste. 110, Bridgeton, MO 63044 | 2019-08-12 |
| 1407300429 | Nicole Becker | Physical Therapist | 12108 Saint Charles Rock Rd, 110, Bridgeton, MO 63044-2601 | 2016-08-08 |
| 1548696727 | Hannah Mcglynn | Physical Therapist | 12380 Depaul Dr, Bridgeton, MO 63044 | 2013-09-19 |
| 1750690293 | Cheryl Holtmeyer | Physical Therapist | 12115 Bridgeton Sq, Bridgeton, MO 63044-2616 | 2010-10-01 |
| 1467769455 | Kelly M Bayzick | Physical Therapist | 310 Beebe Run Rd, Bridgeton, NJ 08302-5679 | 2010-09-12 |
| 1225286495 | Robin Anne Weaver | Physical Therapist | 3662 Bostons Farm Dr, Bridgeton, MO 63044-3167 | 2008-08-29 |
| 1700927274 | Colleen Ronkowski | Physical Therapist | 70 Maneim Avenue, Suite 3, Bridgeton, NJ 08302 | 2007-02-09 |
| 1093821332 | Patricia Ackermann | Physical Therapist | 12955 Enterprise Way, Bridgeton, MO 63044-1206 | 2006-08-21 |
| 1285676155 | Michael Donnelly | Physical Therapist | 313 Beebe Run Rd, Bridgeton, NJ 08302-5680 | 2006-06-12 |
| 1679515027 | Lana Dasilva Allen | Physical Therapist | 3431 Bridgeland Dr, Bridgeton, MO 63044-2604 | 2006-06-11 |
| Find all providers in BRIDGETON | ||||
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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.