NPIMap

Organization Active NPI

West Des Moines Physical Therapy and Sports Rehabilitation, PLLC

Doing business as West Des Moines Physical Therapy

  • Physical Therapist
  • West Des Moines, IA
National Provider Identifier
1073875779
Registry record updated Jun 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4657 Issued in IA
Legal business name
WEST DES MOINES PHYSICAL THERAPY AND SPORTS REHABILITATION, PLLC
Doing business as
West Des Moines Physical Therapy
Practice address
3701 Ep True Pkwy
Suite 300
West Des Moines, IA 50265-7696
Phone
(515) 480-8038
NPI assigned
Jun 9, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2012

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

Authorized official

Name
Dr. Brian Shellenberger, D.P.T.NPI 1073811501
Title
President
Phone
(515) 771-8779

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X 4657 IA Primary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X 4589 IA

Addresses

Primary practice location

3701 Ep True Pkwy
Suite 300
West Des Moines, IA 50265-7696

Mailing address

517 Colonial Cir
West Des Moines, IA 50265-3733
Phone (515) 771-8779

Other names 1

  • West Des Moines Physical Therapy Doing business as

National Provider Directory

National Provider Directory

Locations

1280 Copper Creek Dr
Pleasant Hill, IA 50327
Phone (515) 650-6111

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1339200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339459200000",
    "number": "1073875779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "517 COLONIAL CIR",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502653733",
            "telephone_number": "515-771-8779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 EP TRUE PKWY",
            "address_2": "SUITE 300",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502657696",
            "telephone_number": "515-480-8038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST DES MOINES PHYSICAL THERAPY AND SPORTS REHABILITATION, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-09",
        "last_updated": "2012-06-12",
        "status": "A",
        "authorized_official_last_name": "SHELLENBERGER",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "515-771-8779",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "4657",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "4589",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Des Moines Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2012; 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.