IndividualActive
Kevin Wagner, MD PT CERT MDT
NPI 1295735926 · Physical Therapist · Bridgeton, MO
Provider details
- NPI number
- 1295735926
- Entity type
- Individual
- Primary specialty
- Physical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- MD PT CERT MDT
- Sex
- Male
- Sole proprietor
- No
- License
- 115026 (MO)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES 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
11903 Saint Charles Rock Rd
Bridgeton, MO 63044-2623
Phone: (314) 770-0900
Fax: (314) 770-1673
Street-level locationGet directions
Mailing address
Back Pain Institute of St. Louis LLC
Bridgeton, MO 63044
Registry dates
- Enumerated
- 2005-07-22
- Last updated
- 2010-04-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.