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

Mr. Michael T Wagnon, PT

Individual provider Physical Therapist · NPI 1366491755

Mr. Michael T Wagnon, PT is a Physical Therapist in Private Practice in Lafayette, Colorado. Qualified in 2003, 23 years ago. Practices with Colorado Permanente Medical Group PC, a 1,325-clinician group and accepts Medicare assignment. Licensed in Colorado and New Mexico.

Years since qualifying
23
Licensed in
CO, NM
In the registry since
2006
Specialties on file
2
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

280 Exempla Cir
Lafayette, CO 80026-3370
Phone: (303) 338-4545
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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 9520 (CO)
Physical Therapist Taxonomy 225100000X · Licence 3047 (NM)

Record details

NPI number1366491755
Entity typeIndividual (Type 1)
GenderMale
Credentials PT
Sole proprietorNo
NPI enumeratedMay 10, 2006
Last updated in NPPESMay 20, 2021
Certification dateMay 20, 2021

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2003 (23 years in practice)
Group practice Colorado Permanente Medical Group Pc — 1325 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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