Active NPI
Joseph Connell
- Physical Therapist
- Glenwood, IA
National Provider Identifier
1083072896
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 3331
- Practice address
- 1203 S Locust St
Glenwood, IA 51534-1872 - Phone
- (712) 527-2163
- NPI assigned
- Feb 8, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 3331 | NE | Primary |
| Physical Therapist | 225100000X | 004603 | IA |
Addresses
Primary practice location
1203 S Locust St
Glenwood, IA 51534-1872
Mailing address
55290 Forrester Valley LN
Glenwood, IA 51534-6396
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3331 | NE | MD | Social Worker |
| 004603 | IA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1454889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1454889600000",
"number": "1083072896",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55290 FORRESTER VALLEY LN",
"city": "GLENWOOD",
"state": "IA",
"postal_code": "515346396"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1203 S LOCUST ST",
"city": "GLENWOOD",
"state": "IA",
"postal_code": "515341872",
"telephone_number": "712-527-2163"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONNELL",
"first_name": "JOSEPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-02-08",
"last_updated": "2016-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NE",
"license": "3331",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IA",
"license": "004603",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glenwood, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.