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

Kerry Grimes Wagner, MPT

Individual provider Physical Therapist · NPI 1194049056

Kerry Grimes Wagner, MPT is a Physical Therapist in Private Practice in San Clemente, California. Qualified in 1998, 28 years ago. Practices with One Choice Physical Therapy Inc, an 8-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
28
Licensed in
CA
In the registry since
2010
What do these letters mean?
MPT — Master of Physical Therapy
The master's-level physical therapy degree awarded before the DPT became standard.

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Practice location Address checks out

1120 Via Callejon Ste B
San Clemente, CA 92673-6264
Phone: (949) 481-1095
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT 24160 (CA)

Record details

NPI number1194049056
Entity typeIndividual (Type 1)
GenderFemale
Credentials MPT
Sole proprietorNo
NPI enumeratedMarch 22, 2010
Last updated in NPPESDecember 22, 2011

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 1998 (28 years in practice)
Group practice One Choice Physical Therapy Inc — 8 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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