KERRY GRIMES WAGNER MPT
NPI 1194049056
Physical Therapist in San Clemente, CA

Active since March 22, 2010Accepts Medicare Assignment
1120 VIA CALLEJON STE B, SAN CLEMENTE, CA 92673(949) 481-1095 Get Directions Write a Review

NPPES record last updated: December 22, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kerry Grimes Wagner Mpt NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KERRY GRIMES WAGNER MPT (NPI 1194049056) is an individual physical therapist in San Clemente, California, licensed in California (PT 24160) and active in the NPI registry since March 2010. She is a graduate of Other (1998).

NPPES Registry Identity

NPI1194049056
Entity TypeIndividualFemale
Primary Taxonomy225100000X
Provider Legal NameKERRY GRIMES WAGNERCredential: MPT
Location Address1120 VIA CALLEJON STE BSan Clemente, CA 92673-6264
Mailing Address1120 Via Callejon Ste BSan Clemente, CA 92673-6264 · (949) 481-1095
Sole ProprietorNo
Medical School CMSOtherGraduated 1998
Enumeration DateMarch 22, 2010
Last NPPES UpdateDecember 22, 2011
NPI 1194049056 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225100000X
License Licensed in CA · PT 24160
Definition
Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles. PTs:
  • Diagnose and manage movement dysfunction and enhance physical and functional abilities.
  • Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
  • Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
  • Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
  • Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.
PTs provide care for people in a variety of settings, including hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes. State licensure is required in each state in which a PT practices.
1120 VIA CALLEJON STE B, San Clemente, CA 92673

Other Identifiers 1

Medicare PINFQ415ZCA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Kerry Grimes Wagner Mpt is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2567638612
PECOS Enrollment IDI20111220000773

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92673 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$96.36 typical visit price
range $62.96 – $187.60
Typical copayment $24.09 (range $15.74 – $46.90)
Most-billed visit code 99203
Established Patient
$77.96 typical visit price
range $20.84 – $153.61
Typical copayment $19.49 (range $5.21 – $38.40)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Specialist
1120 VIA CALLEJON STE B
SAN CLEMENTE, CA 92673
Occupational Therapist (Pediatrics)
1120 VIA CALLEJON STE B
SAN CLEMENTE, CA 92673
Occupational Therapy Assistant
1120 VIA CALLEJON STE B
SAN CLEMENTE, CA 92673
Occupational Therapy Assistant
1120 VIA CALLEJON STE B
SAN CLEMENTE, CA 92673
Specialist/Technologist (Speech-Language Assistant)
1120 VIA CALLEJON STE B
SAN CLEMENTE, CA 92673
Occupational Therapist (Pediatrics)
1120 VIA CALLEJON STE B
SAN CLEMENTE, CA 92673
Occupational Therapist (Pediatrics)
1120 VIA CALLEJON STE B
SAN CLEMENTE, CA 92673
Specialist/Technologist (Speech-Language Assistant)
1120 VIA CALLEJON STE B
SAN CLEMENTE, CA 92673

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kerry Wagner's NPI number?

The NPI number for Kerry Wagner is 1194049056. It was assigned to this individual provider in the NPPES registry on March 22, 2010.

Where is Kerry Wagner located?

Kerry Wagner practices at 1120 Via Callejon Ste B, San Clemente, CA 92673. The listed phone number is (949) 481-1095.

What is Kerry Wagner's specialty?

The primary specialty registered for this NPI is Physical Therapist with taxonomy code 225100000X.

Is Kerry Wagner enrolled in Medicare?

Yes. Kerry Wagner is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Kerry Wagner was last updated on December 22, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.