Organization Active NPI

Physical Therapy Specialists PC

  • Physical Therapist
  • Sioux City, IA
National Provider Identifier
1063448801
Registry record updated Sep 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PHYSICAL THERAPY SPECIALISTS PC
Practice address
915 Pierce St.
Sioux City, IA 51101-1031
Phone
(712) 234-8760
Fax
(712) 234-8765
NPI assigned
Jun 23, 2006
Last updated
Sep 18, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kevin G Poss, DPTNPI 1770563033
Title
Co Owner
Phone
(712) 234-8760

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU
Physical Therapist 225100000X IA Primary
Durable Medical Equipment & Medical Supplies 332B00000X IA

Addresses

Primary practice location

915 Pierce St.
Sioux City, IA 51101-1031

Mailing address

PO Box 1533
Physical Therapy Specialists PC
Sioux City, IA 51102-1533
Phone (712) 234-8760

Other identifiers 3

IdentifierTypeStateIssuer
214924MedicaidIA
0214924MedicaidIA
CH1150OtherIARR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151008003153 IA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 6800799271 Receives reassigned benefits from 6 practitioners
Practice locations: Sioux City, IA

National Provider Directory

National Provider Directory

Locations

2800 Pierce St
Ste 108
Sioux City, IA 51104
Phone (712) 234-8760

915 Pierce St
Sioux City, IA 51101
Phone (712) 234-8760

150 Tower Rd
Ste 115
Dakota Dunes, SD 57049
Phone (605) 540-4491

317 Dakota Dunes Blvd
Ste D
Dakota Dunes, SD 57049
Phone (605) 242-5016

345 W Steamboat Dr
Ste 403
Dakota Dunes, SD 57049
Phone (605) 242-5016

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442534400000",
    "number": "1063448801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1533",
            "address_2": "PHYSICAL THERAPY SPECIALISTS PC",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511021533",
            "telephone_number": "712-234-8760",
            "fax_number": "712-234-8765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 PIERCE ST.",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511011031",
            "telephone_number": "712-234-8760",
            "fax_number": "712-234-8765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL THERAPY SPECIALISTS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-23",
        "last_updated": "2015-09-18",
        "status": "A",
        "authorized_official_last_name": "POSS",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "CO OWNER",
        "authorized_official_telephone_number": "712-234-8760",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "214924",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0214924",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CH1150",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.