MR. KEVIN MATTHEW WAGNER (MD PT CERT MDT) – Physical Therapist, NPI 1295735926

MR. KEVIN MATTHEW WAGNER (MD PT CERT MDT) is a healthcare provider. based in Bridgeton, Missouri. specializing in Physical Therapist. They hold the professional credentials MD PT CERT MDT. They hold a License No. 115026 (MO). The NPI Number for MR. KEVIN MATTHEW WAGNER (MD PT CERT MDT) is 1295735926

Main info

Male
Name
MR. KEVIN MATTHEW WAGNER (MD PT CERT MDT)
NPI
1295735926
Phone
(314) 770-0900
Address
11903 SAINT CHARLES ROCK RD
Enumeration Date
22 July 2005
Last Update Date
29 April 2010
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for MR. KEVIN MATTHEW WAGNER (MD PT CERT MDT)

  • 11903, Saint Charles Rock Road, Bridgeton, Saint Louis County, Missouri, 63044, United States

    BRIDGETON, MO 630442623

    Phone: (314) 770-0900

    Fax: (314) 770-1673

    Type: Location

  • BACK PAIN INSTITUTE OF ST. LOUIS LLC

    11903 ST. CHARLES ROCK RD.

    BRIDGETON, MO 63044

    Phone: (314) 770-0900

    Fax: (314) 739-8569

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

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Medicare Enrollment & Revalidation

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No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

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Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 63044)

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Reviews

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Frequently asked questions

What federal number belongs to MR. KEVIN MATTHEW WAGNER (MD PT CERT MDT)?
The federal identifier for MR. KEVIN MATTHEW WAGNER (MD PT CERT MDT) is NPI 1295735926.
Is MR. KEVIN MATTHEW WAGNER (MD PT CERT MDT)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What field does MR. KEVIN MATTHEW WAGNER (MD PT CERT MDT) work in?
You can think of MR. KEVIN MATTHEW WAGNER (MD PT CERT MDT) as practicing within Physical Therapist. Clinical services aligned with this taxonomy classification.
What location shows for MR. KEVIN MATTHEW WAGNER (MD PT CERT MDT)?
We surface Bridgeton, Missouri for MR. KEVIN MATTHEW WAGNER (MD PT CERT MDT) based on available NPPES addresses.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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