Blake Douglas Wagner, PT
Physical Therapist · Fremont, NE
Blake Douglas Wagner, PT is a physical therapist with a practice address in Fremont, Nebraska, and NPI 1811057664, issued on Dec 11, 2006. Check the license (Nebraska 1004, as entered in NPPES) with the Nebraska board that licenses this profession; the Medicare figures below come from public CMS files.
- Name
- Blake Douglas Wagner
- Credential
- PT
- Primary taxonomy
- Physical Therapist 225100000X
- License numbers
- 1004 NE
01883 IA
Self-reported in NPPES; status is on the state search - Practice location
- 410 E 22ND St Ste 2, Fremont, NE 68025
- Phone
- (800) 974-4378
- Enumerated
- Dec 11, 2006
- Record last updated
- Oct 30, 2023
- Fax
- (630) 515-1536
- Medicaid ID
- 0762989 IA
- Entity
- Type 1 · individual
8 nearest physical therapist records → All 2,093 in Nebraska → Look up another NPI →
Also registered at 410 E 22ND St Ste 2
A shared address usually means a shared clinic or building; it does not show who employs whom.
- Jonathon Free, DPTPhysical Therapist1659852036
Verify Blake Douglas Wagner in five checks
- 1IdentityNPI record in CMS NPPESNPI lookupConfirmed in NPPES
- 2LicenseActive license and public ordersWhich Nebraska board licenses this profession
Search for license 1004Check the board - 3Other statesLicenses and actions elsewhereDocInfo (FSMB)Not checked
- 4ExclusionsMedicare and Medicaid bansHHS-OIG exclusion listNot checked
- 5CertificationBoard certificationABMS AOA NCCPA AANPNot checked
The practice group's MIPS final score for 2023 (Medicare payment program): 100 of 100
The Merit-based Incentive Payment System score is reported for the practice group, not for one clinician alone. Four categories are weighted into the final score; the average among 454,083 clinicians with a measured score was 83.5.
Source: CMS Quality Payment Program, MIPS performance year 2023, group reporting; category weights for 2023 (qpp.cms.gov).
Blake Douglas Wagner among 2,093 physical therapist records in Nebraska
Blake Douglas Wagner, PT is one of 2,093 physical therapist records with a practice address in Nebraska. 34% of them appear in a Medicare file (Part D prescribing, MIPS, Open Payments or Medicare group billing); this one does. Its NPI, issued in 2006, is newer than 2% of them.
- NPI issued2006 · 2% of these records are older, 83% newer
- In a Medicare fileYes · 34% of these records are
- In the CMS Doctors and Clinicians fileNo · 35% of these records are
- Record last updated2023 · 64% of these records were not updated in five years or more
Source: CMS NPPES, file of Aug 9, 2026, every record with primary taxonomy 225100000X and a Nebraska practice address; Medicare files: CMS Part D Prescribers 2024, MIPS 2023, Open Payments 2024, Doctors and Clinicians (data.cms.gov).
51 physical therapist records list a practice address in Fremont
They are 51 of the 922 NPPES records with a practice address in Fremont, and 2,093 physical therapist records in Nebraska.
All 2,093 in Nebraska → Every provider in Fremont → Physical Therapist nationwide →
The 8 physical therapist records with the nearest ZIP codes
- Ashley BeltFremont, NE 680251699794099
- Fred Brown, PTFremont, NE 680251598707507
- Philip Davidson, MPTFremont, NE 680251679555999
- Chris Demuth, DPTFremont, NE 680251871519785
- Danielle Helton, DPTFremont, NE 680251386836690
- Bror Ljungqvist, P.TFremont, NE 680251831306539
- Jeree Menning, P.T.Fremont, NE 680251932207339
- William Paschall, P.T.Fremont, NE 680251942420898
Common questions
What is Blake Douglas Wagner, PT's NPI number?
Blake Douglas Wagner, PT's National Provider Identifier (NPI) is 1811057664, issued on Dec 11, 2006. An NPI identifies a provider in billing; it is not a license.
Where is Blake Douglas Wagner, PT located?
The NPPES record lists a practice address at 410 E 22ND St Ste 2, Fremont, NE, 68025. Phone: (800) 974-4378. Providers update this record themselves, so call before visiting.
How can I verify Blake Douglas Wagner, PT's license?
NPPES lists Nebraska license number 1004, as entered by the provider. Search the Nebraska board that licenses this profession; the NPPES record confirms identity only.
What is Blake Douglas Wagner, PT's MIPS final score?
The 2023 MIPS final score is 100 of 100, reported for the practice group. The average among 454,083 clinicians with a measured score was 83.5.
Source: CMS National Plan and Provider Enumeration System (NPPES), file of Aug 9, 2026 (NPPES files on CMS.gov); NUCC Health Care Provider Taxonomy. Medicare files from data.cms.gov. An NPI identifies who bills; it is not a license.
Figures on PlainDoctor are read from the federal files each page names (CMS NPPES, Medicare Part D, MIPS, Open Payments; the HHS-OIG exclusion list only as counts) and from Census population estimates, with the file date shown beside them. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error. Data current as of Aug 9, 2026.