Organization Active NPI

Physical Therapy and Rehabilitation Specialist Inc.

  • Rehabilitation Practitioner
  • Adel, IA
National Provider Identifier
1104904168
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
Legal business name
PHYSICAL THERAPY AND REHABILITATION SPECIALIST INC.
Practice address
1205 Greene St
Adel, IA 50003-1715
Phone
(515) 993-3517
Fax
(515) 993-5473
NPI assigned
Nov 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Carolyn McVay
Title
Office Manager
Phone
(515) 993-3517

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 225400000X Primary

Addresses

Primary practice location

1205 Greene St
Adel, IA 50003-1715

Mailing address

1205 Greene St
Adel, IA 50003-1715
Phone (515) 993-3517

Other identifiers 2

IdentifierTypeStateIssuer
66504OtherIABLUE CROSS
0665042MedicaidIA

National Provider Directory

National Provider Directory

Locations

1205 Greene St
Adel, IA 50003
Phone (515) 993-3517

Practitioners & affiliated clinicians

Practitioners 2

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": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104904168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 GREENE ST",
            "city": "ADEL",
            "state": "IA",
            "postal_code": "500031715",
            "telephone_number": "515-993-3517",
            "fax_number": "515-993-5473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 GREENE ST",
            "city": "ADEL",
            "state": "IA",
            "postal_code": "500031715",
            "telephone_number": "515-993-3517",
            "fax_number": "515-993-5473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL THERAPY AND REHABILITATION SPECIALIST INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCVAY",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "515-993-3517"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "66504",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0665042",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Adel, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.