Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jordan Wagner

Individual provider Pediatric Physical Therapist · NPI 1548145402

Jordan Wagner is a Pediatric Physical Therapist in Virginia Beach, Virginia. Practices as a sole proprietor. Licensed in Virginia.

Licensed in
VA
In the registry since
2025

Practice location Address checks out

1400 Fordham Dr
Virginia Beach, VA 23464-5368
Phone: (757) 361-3951
Show map & directions

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

Specialties & licences

Pediatric Physical Therapist (primary) Taxonomy 2251P0200X · Licence 2305217318 (VA)

Record details

NPI number1548145402
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedAugust 9, 2025
Last updated in NPPESAugust 13, 2025
Certification dateAugust 13, 2025

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