Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Jack Wagner

Individual provider Physical Therapist · NPI 1962398131

Jack Wagner is registered under Physical Therapist in Private Practice in Indianapolis, Indiana. Qualified in 2025, 1 year ago. Practices with Team Rehabilitation Services LLC, a 569-clinician group and accepts Medicare assignment. Licensed in Indiana.

Years since qualifying
1
Licensed in
IN
In the registry since
2025
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

8628 Purdue Rd
Indianapolis, IN 46268-1114
Phone: (317) 677-0660
Fax: (317) 667-0640
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 05016107A (IN)

Record details

NPI number1962398131
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJune 16, 2025
Last updated in NPPESAugust 8, 2025
Certification dateAugust 8, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Team Rehabilitation Services Llc — 569 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Colleagues at Team Rehabilitation Services LLC

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 569 clinicians in the practice; 12 are shown here.

Other providers in Indianapolis