Kenneth Wagoner, PTA
NPI 1164393674 · Physical Therapy Assistant · Statesville, NC
Kenneth Wagoner, PTA is a Physical Therapy Assistant provider in Statesville, NC (NPI 1164393674).
Provider details
- NPI number
- 1164393674
- Entity type
- Individual
- Primary specialty
- Physical Therapy AssistantRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- PTA
- Sex
- Male
- Sole proprietor
- No
- License
- A8675 (NC)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
Under 1 yr in registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2025-09-16
- Last updated
- 2025-09-16
- Certified
- 2025-09-16
Frequently asked questions
- What is Kenneth Wagoner's NPI number?
- Kenneth Wagoner's National Provider Identifier (NPI) is 1164393674, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Kenneth Wagoner's specialty?
- Kenneth Wagoner is listed in the NPPES registry with a primary specialty of Physical Therapy Assistant (Respiratory, Developmental, Rehabilitative and Restorative Service Providers).
- Where is Kenneth Wagoner located?
- Kenneth Wagoner's practice location on file with NPPES is 1845 E Broad St, Statesville, NC 28625-4307.
- What is Kenneth Wagoner's phone number?
- The practice phone number listed in the NPPES registry for Kenneth Wagoner is (980) 890-3255.
- Is Kenneth Wagoner's NPI active?
- Yes — Kenneth Wagoner's NPI (1164393674) is active in the NPPES registry as of the last update on 2025-09-16.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.