Individual provider Active NPI

Michelle Herbst, MPT

  • Physical Therapist
  • Ankeny, IA
National Provider Identifier
1073614566
Registry record updated Sep 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3035 Issued in IA
Practice address
1555 SE Delaware Ave
Suite M
Ankeny, IA 50021-4011
Phone
(515) 963-8723
Fax
(515) 963-8755
NPI assigned
Sep 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 3035 IA Primary

Addresses

Primary practice location

1555 SE Delaware Ave
Suite M
Ankeny, IA 50021-4011

Mailing address

5900 NW 86TH St
Suite 200
Johnston, IA 50131-2284
Phone (515) 278-8151

Other identifiers 1

IdentifierTypeStateIssuer
0665430MedicaidIA

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
03035IAMDCardiovascular Disease Physician
3035IAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316995200000",
    "number": "1073614566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 NW 86TH ST",
            "address_2": "SUITE 200",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501312284",
            "telephone_number": "515-278-8151",
            "fax_number": "515-278-8155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 SE DELAWARE AVE",
            "address_2": "SUITE M",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500214011",
            "telephone_number": "515-963-8723",
            "fax_number": "515-963-8755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERBST",
        "first_name": "MICHELLE",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2011-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "3035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0665430",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ankeny, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.