NPIMap

Organization Active NPI

21St Century Rehab PC

  • Rehabilitation Clinic/Center
  • Indianola, IA
National Provider Identifier
1174783583
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
21ST CENTURY REHAB PC
Practice address
1507 N 1St St
Indianola, IA 50125-3703
Phone
(515) 961-7435
Fax
(515) 961-7436
NPI assigned
Jun 10, 2008
Organization subpart
Yes
Parent organization
21ST CENTURY REHAB PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 27, 2025

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 IA Primary

Addresses

Primary practice location

1507 N 1St St
Indianola, IA 50125-3703

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
0665810MedicaidIA
36587OtherIAWELLMARK BCBS

Other names 1

  • Indianola Physical Therapy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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
This NPI is an additional NPI on the 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
Part of
Twenty First Century

Locations

1003 8th St SW
Ste D2E
Altoona, IA 50009

1504 S Story St
Ste 6
Boone, IA 50036
Phone (515) 236-9014

130 N 1st St
Carlisle, IA 50047
Phone (515) 989-0100

1507 N 1st St
Indianola, IA 50125
Phone (515) 961-7435

209 W 2nd St
Madrid, IA 50156
Phone (515) 795-2427

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 43

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

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1213056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740614400000",
    "number": "1174783583",
    "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": "1507 N 1ST ST",
            "city": "INDIANOLA",
            "state": "IA",
            "postal_code": "501253703",
            "telephone_number": "515-961-7435",
            "fax_number": "515-961-7436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "21ST CENTURY REHAB PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "21ST CENTURY REHAB PC",
        "enumeration_date": "2008-06-10",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "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": "IA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0665810",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BCBS",
            "identifier": "36587",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Indianola Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Indianola, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2025; 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.