Bryan Wagner, OT, ATC, LAT
NPI 1871016295 · Occupational Therapist · Jacksonville, FL
Provider details
- NPI number
- 1871016295
- Entity type
- Individual
- Primary specialty
- Occupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- OT, ATC, LAT
- Sex
- Male
- Sole proprietor
- No
- License
- AL4839 (FL)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
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
8 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
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
Additional practice locations (1)
- 1045 Riverside Ave190Jacksonville, FL 32201Phone: (904) 647-4284
Registry dates
- Enumerated
- 2017-07-18
- Last updated
- 2024-10-21
- Certified
- 2024-10-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.