MR. WILLIAM WALLACE WAGGONER (PT) – Physical Therapist, NPI 1255368049
Physical Therapist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,866 PHYSICAL THERAPIST IN PRIVATE PRACTICE in IN
Provider Addresses for MR. WILLIAM WALLACE WAGGONER (PT)
Harper Avenue, Saint Clair Shores, Clinton Township, Macomb County, Michigan, 48036, United States
CLINTON TWP, MI 480354258
Phone: (586) 350-2644
Type: Mailing
500 SAGAMORE PKWY W STE 2W
WEST LAFAYETTE, IN 479061459
Phone: (765) 250-9660
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
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Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2009-03-16
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20090316000663 | I | Physical Therapist In Private Practice | IN | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 97530 | Therapy procedure using functional activities | 1,578 | 68 | $0 |
| 97140 | Therapy procedure using manual technique, each 15 minutes | 808 | 58 | $0 |
| 97112 | Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes | 702 | 67 | $0 |
| 97110 | Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | 564 | 61 | $0 |
| 97535 | Training for self-care or home management, each 15 minutes | 125 | 54 | $0 |
Insurance plans in this area (ZIP 48035)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PHYSICAL THERAPY | IN | 97001 | Physical therapy evaluation | 27 | 25 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Physical Therapist In Private Practice | MI | |
| Physical Therapist In Private Practice | MI | |
| Physical Therapist In Private Practice | MI | |
| Physical Therapist In Private Practice | MI | |
| Physical Therapist In Private Practice | MI | |
| Physical Therapist In Private Practice | TN | |
| Physical Therapist In Private Practice | IL | |
| Physical Therapist In Private Practice | MI | |
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| Physical Therapist In Private Practice | GA |
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