BLAIR ELLEN WAGONER (NPI# 1891939344) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891939344 |
| Entity Type | Individual |
| Full Name | BLAIR ELLEN WAGONER |
| Practice Address |
1001 Monarch St Suite 110 Lexington KY 40513-1495 |
| Mailing Address |
115 West Dr Murray KY 42071-9830 |
| Practice Telephone | 8592240834 |
| Mailing Telephone | 2702930758 |
| Enumeration Date | 2009-04-28 |
| Last Update Date | 2010-04-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 225100000X | Physical Therapist | PT 3141 | AR | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Y | 2251P0200X |
Physical Therapist Specialization: Pediatrics |
PT005412 | KY | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
1001 MONARCH ST SUITE 110 |
| City | LEXINGTON |
| State | KY |
| Zip Code | 40513-1495 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841308764 | Lde, Md, Pllc | Internal Medicine | 1001 Monarch St, Ste 110, Lexington, KY 40513-1848 | 2006-08-29 |
| 1568829802 | Garnett C. Brown IIi D.m.d. Psc | Dentist | 1001 Monarch St, Suite 200, Lexington, KY 40513-1495 | 2016-01-18 |
| 1104144336 | Miranda Wynn Bullock-davidson | Speech-Language Pathologist | 1001 Monarch St, Ste. 110, Lexington, KY 40513-1495 | 2010-05-12 |
| 1619110194 | Jennifer Liggett Hellard | Speech-Language Pathologist | 1001 Monarch St, Suite 110, Lexington, KY 40513-1848 | 2009-04-13 |
| 1811148935 | On The Move Pediatric Therapy | Physical Therapist | 1001 Monarch St, Suite 110, Lexington, KY 40513-1848 | 2008-10-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861991531 | Angela C Dehart, Lcsw | Social Worker | 1040 Monarch St Ste 110, Lexington, KY 40513 | 2018-02-07 |
| 1831623313 | Dustin Mayrand | Student in an Organized Health Care Education/Training Program | 3141 Beaumont Centre Cir Ste 300, Lexington, KY 40513 | 2017-04-12 |
| 1992253249 | Apollo Laboratory Science and Technology Services | Clinical Medical Laboratory | 3191 Beaumont Centre Cir Ste 150, Lexington, KY 40513 | 2016-09-15 |
| 1457751174 | Kentucky One Health | Community/Behavioral Health | 3251 Beaumont Circle, Saint Joseph Healthy Lifestyle Center, Lexington, KY 40513 | 2014-08-29 |
| 1063777316 | Baptist Physicians Lexington, Inc | Internal Medicine | 3084 Lakecrest Circle, Suite 100, Lexington, KY 40513 | 2012-07-11 |
| 1346524329 | Katherina Terhune | Social Worker | 1000 Monarch Street, #250, Lexington, KY 40513 | 2011-10-07 |
| 1619206539 | Beamont Chiropractic LLC | Chiropractor | 3160 Beaumont Circle, Suite 130, Lexington, KY 40513 | 2009-12-24 |
| 1659604197 | Thomas Fordham Brewer | Preventive Medicine | 3234 Beacon St., Lexington, KY 40513 | 2009-09-16 |
| 1033368931 | Katy M Breeze | Pharmacist | #2573 Palomar Centre Dr, Rite Aid Pharmacy, Lexington, KY 40513 | 2008-09-16 |
| 1356485890 | Muscle & Rom Testing LLC | Specialist | 3726 Military Pike, Lexington, KY 40513 | 2007-02-17 |
| Find all providers in zip 40513 | ||||
| Taxonomy Code | 2251P0200X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902210099 | Heidi Mella | Physical Therapist | 8137 Tates Creek Rd, Lexington, KY 40515-8000 | 2014-06-17 |
| 1518379775 | Amy Ray | Physical Therapist | 4056 Palomar Blvd, Lexington, KY 40513-1320 | 2014-05-22 |
| 1982956751 | Jordan Leigh Bennett | Physical Therapist | 101 Pine St Apt 205, Lexington, KY 40508-3042 | 2012-10-03 |
| 1891835666 | Ot4kids, Inc. | Physical Therapist | 1106 E Center St, Lexington, NC 27292-4433 | 2007-02-08 |
| 1770957029 | Jessica Virgadamo | Physical Therapist | 175 W Lowry Ln, Suite 104, Lexington, KY 40503-3012 | 2015-11-24 |
| 1255734083 | Mary Poblete | Physical Therapist | 4 Militia Dr, Suite 17, Lexington, MA 02421-4737 | 2014-10-07 |
| 1043656945 | Jessica Nicole Raspen | Physical Therapist | 290 Alumni Dr, Lexington, KY 40503-1601 | 2013-05-17 |
| 1285977462 | Wilson Pediatric Therapy LLC | Physical Therapist | 424 Lewis Hargett Cir # B-100, Lexington, KY 40503-3688 | 2013-04-05 |
| 1811148935 | On The Move Pediatric Therapy | Physical Therapist | 1001 Monarch St, Suite 110, Lexington, KY 40513-1848 | 2008-10-07 |
| 1053468090 | Midlands Therapy Services, Inc. | Physical Therapist | 225 Vista Springs Cir, Lexington, SC 29072-8119 | 2007-01-04 |
| Find all providers in LEXINGTON | ||||
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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.