Individual provider Active NPI

Dustin James Reinbold, P.T.

  • Physical Therapist
  • Lincoln, NE
National Provider Identifier
1154400943
Registry record updated Jun 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2520 Issued in NE
Practice address
5633 NW 1St St
Lincoln, NE 68521-4465
Phone
(402) 434-5905
Fax
(402) 434-5902
NPI assigned
Nov 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 03154 IA
Physical Therapist 225100000X 2520 NE Primary

Addresses

Primary practice location

5633 NW 1St St
Lincoln, NE 68521-4465

Mailing address

5401 South St
Lincoln, NE 68506-2150
Phone (402) 434-5905

Other identifiers 2

IdentifierTypeStateIssuer
0488759MedicaidIA
38762OtherIABC/BS

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
2520NEMDClinical Social Worker
03154IAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sioux City Physical Therapy PC Physical Therapist PastSince Nov 12, 2001 Accepting new patients
Madonna Rehabilitation Hospital Past Accepting new patients
Madonna Rehabilitation Hospital Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245801600000",
    "number": "1154400943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5401 SOUTH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685062150",
            "telephone_number": "402-434-5905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5633 NW 1ST ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685214465",
            "telephone_number": "402-434-5905",
            "fax_number": "402-434-5902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REINBOLD",
        "first_name": "DUSTIN",
        "middle_name": "JAMES",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-03",
        "last_updated": "2009-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "03154",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "2520",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0488759",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "38762",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2009; 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.