Type 1 · Individual ✓ Active NPI ✓ Valid NPI checksum
Blake Douglas Wagner, PT
Physical Therapist in Fremont, NE · enumerated 2006.
Data current as of Jul 13, 2026 · sourced from CMS NPPES
National Provider Identifier
1811057664
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Registry record
Entity type Individual (Type 1)
Name Blake Douglas Wagner
Credential PT
Sex Male
Practice address 410 E 22nd St Ste 2, Fremont, NE, 68025
Phone (800) 974-4378
Fax (630) 515-1536
Enumeration date Dec 11, 2006
Last updated in NPPES Oct 30, 2023
Taxonomy & licenses
225100000X Physical Therapist Respiratory, Developmental, Rehabilitative and Restorative Service Providers · License 01883 (IA) Secondary
225100000X Physical Therapist Respiratory, Developmental, Rehabilitative and Restorative Service Providers · License 1004 (NE) Primary
PT · Physical Therapist: A licensed movement specialist treating injury and disability through exercise and rehabilitation.
About the PT credential
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 29675 | Other | IA | BCBS IA-WELLMARK |
| 0762989 | Medicaid | IA | - |
| P00636067 | Other | IA | RR MEDICARE |
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.
Frequently asked questions
How do I verify Blake Wagner's NPI record?
Cross-check NPI 1811057664 against the official CMS registry at npiregistry.cms.hhs.gov. This page mirrors the same public NPPES data with a monthly snapshot.
Is NPI 1811057664 active?
Yes, as of the latest NPPES snapshot, NPI 1811057664 is active (record last updated 2023-10-30).
Other providers at this practice address
Browse all →Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2023-10-30.