NPIMap

Organization Active NPI

21St Century Rehab, PC

  • Rehabilitation Clinic/Center
  • Altoona, IA
National Provider Identifier
1114963154
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
21ST CENTURY REHAB, PC
Practice address
1003 8TH St SW Ste D
Altoona, IA 50009-2350
Phone
(515) 967-4124
Fax
(515) 967-9094
NPI assigned
Jun 20, 2006
Last updated
Nov 19, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
21ST CENTURY REHAB, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Authorized official

Name
Michelle R Cassabaum
Title
Cfo
Phone
(515) 382-3366

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X Primary

Addresses

Primary practice location

1003 8TH St SW Ste D
Altoona, IA 50009-2350

Mailing address

PO Box 461
Nevada, IA 50201-0461
Phone (515) 382-3366

Other identifiers 6

IdentifierTypeStateIssuer
F1001OtherMIDLANDS
0665547MedicaidIA
154075OtherIOWA HEALTH SOLUTIONS
66554OtherBCBS ALTOONA
139763501OtherOWCP FED WC ALTOONA
3432608OtherPREMIER PROV NETWK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20110914000317 IA Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 1456250448 Practice locations: Altoona, IA
O20250411001117 IA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 1456250448 Receives reassigned benefits from 31 practitioners
2 other NPIs on this enrollment
Practice locations: Boone, IA; Osceola, IA; Madrid, IA; Indianola, IA; Carlisle, IA; Altoona, IA

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Twenty First Century Re2 organizations share this tax ID, including this one
Part of
Twenty First Century Re

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

612 8th St SW
Altoona, IA 50009
Phone (515) 967-4124

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 31

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.

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731974400000",
    "number": "1114963154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 461",
            "city": "NEVADA",
            "state": "IA",
            "postal_code": "502010461",
            "telephone_number": "515-382-3366",
            "fax_number": "515-382-1576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 8TH ST SW STE D",
            "city": "ALTOONA",
            "state": "IA",
            "postal_code": "500092350",
            "telephone_number": "515-967-4124",
            "fax_number": "515-967-9094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "21ST CENTURY REHAB, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "21ST CENTURY REHAB, PC",
        "enumeration_date": "2006-06-20",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A",
        "authorized_official_last_name": "CASSABAUM",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "515-382-3366"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS",
            "identifier": "F1001",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0665547",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IOWA HEALTH SOLUTIONS",
            "identifier": "154075",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ALTOONA",
            "identifier": "66554",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OWCP FED WC ALTOONA",
            "identifier": "139763501",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREMIER PROV NETWK",
            "identifier": "3432608",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Altoona, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; 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.