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

Laura Jane Bagwell

Individual provider Physical Therapist · NPI 1730632555

Laura Jane Bagwell is a Physical Therapist in Private Practice in Garner, North Carolina. Qualified in 2016, 10 years ago. Practices with Tidewater Physical Therapy LLC, a 222-clinician group and accepts Medicare assignment. Licensed in North Carolina and Virginia.

Years since qualifying
10
Licensed in
NC, VA
In the registry since
2016
Specialties on file
2

Practice location Address checks out

510 Timber Dr E Ste 102
Garner, NC 27529-5285
Phone: (919) 500-5003
Show map & directions

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

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence P24080 (NC)
Physical Therapist Taxonomy 225100000X · Licence 2305210453 (VA)

Record details

NPI number1730632555
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJuly 28, 2016
Last updated in NPPESJune 24, 2025
Certification dateJune 24, 2025
Mailing address2122 York Rd Ste 300, Oak Brook, IL 60523-1925

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Tidewater Physical Therapy Llc — 222 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Garner