| Adeline Wagner, | |
|
1115 Boulders Pkwy Ste 100a, North Chesterfield, VA 23225-4067 | |
| (804) 379-9086 | |
| (804) 267-1673 |
| Full Name | Adeline Wagner |
|---|---|
| Gender | Female |
| Speciality | Occupational Therapist In Private Practice |
| Experience | 2 Years |
| Location | 1115 Boulders Pkwy Ste 100a, North Chesterfield, Virginia |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407687627 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225X00000X | Occupational Therapist | 0119010516 (Virginia) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Ivyrehab Sept, Llc | 7911990908 | 216 |
| Provider Name | Ivyrehab Sept, LLC |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1982657433 PECOS PAC ID: 7911990908 Enrollment ID: O20240202000799 |
| Mailing Address | Practice Location Address |
|---|---|
| Adeline Wagner, Po Box 715868, Philadelphia, PA 19171-5868 Ph: (804) 915-1910 | Adeline Wagner, 1115 Boulders Pkwy Ste 100a, North Chesterfield, VA 23225-4067 Ph: (804) 379-9086 |
Stella Matthews, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 8005 W Mount Bella Rd, North Chesterfield, VA 23235 Phone: 866-370-8206 |
Meghan O Reynolds, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 9325 Midlothian Tpke Ste A, North Chesterfield, VA 23235 Phone: 757-490-3223 Fax: 757-490-2936 |
Tatiana Schrader, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 9325 Midlothian Tpke Ste A, North Chesterfield, VA 23235 Phone: 757-490-3223 |
Miss Blair Mallory, OTR Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 9325 Midlothian Tpke Ste A, North Chesterfield, VA 23235 Phone: 757-490-3223 Fax: 757-490-3223 |
Kristi K Gregory, MS OTRL CHT Occupational Therapist Medicare: Accepting Medicare Assignments Practice Location: 1115 Boulders Pkwy Ste 100a, North Chesterfield, VA 23225 Phone: 804-379-9086 Fax: 804-267-1673 |
Ms. Sarah Emily Hopkins, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 9919 Castle Glen Ter, North Chesterfield, VA 23236 Phone: 804-647-3613 |
Danielle Moll, OT Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 9325 Midlothian Tpke Ste A, North Chesterfield, VA 23235 Phone: 757-490-3223 |