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Individual provider Active NPI Physical Therapist · Peru, IN

NPI 1033052303 · NPPES record last updated Apr 13, 2026

Key facts

NPI
1033052303
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
Practice address
2 Broadway PLZ
Peru, IN 46970-1052
Phone
(765) 753-8829
NPI assigned
Apr 13, 2026
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare Care Compare profile

Specialty
Physical Therapist in Private Practice
Education
Other, 2026
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Boston, MA 02241

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Path Physical Therapist Current
since Jun 23, 2026
Accepting new patients
Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Pathology, PLLC Past
since Jun 23, 2026
Accepting new patients

Locations

2 Broadway Plz
Peru, IN 46970
Phone (765) 753-8829

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Yes

Addresses

Primary practice location

2 Broadway PLZ
Peru, IN 46970-1052

Mailing address

2 Broadway PLZ
Peru, IN 46970-1052
Phone (765) 753-8829

Other providers in Peru, IN

All providers in Peru, IN · Physical Therapist in Indiana

Sources for this page

Verify at the official NPI Registry.