Individual provider Active NPI

Joelle Gallick, PT, DPT

  • Physical Therapist
  • Des Moines, IA
National Provider Identifier
1174878938
Registry record updated Jul 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
004959 Issued in IA
Practice address
3209 Ingersoll Ave
Suite 100
Des Moines, IA 50312-3929
Phone
(515) 282-4560
Fax
(515) 282-4570
NPI assigned
Jul 18, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 004959 IA Primary

Addresses

Primary practice location

3209 Ingersoll Ave
Suite 100
Des Moines, IA 50312-3929

Mailing address

3209 Ingersoll Ave
Suite 100
Des Moines, IA 50312-3929
Phone (515) 282-4560

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121105000399 IA Practitioner - Physical Therapist in Private Practice 2264683036 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athletico LTDGroup PAC ID 4789602681, 2,187 clinicians

Practice addresses (Care Compare)

1604 NW State St
Suite 101And102 Athletico Physical Therapy
Ankeny, IA 50023-1464
Phone (515) 965-4594

1704 Ingersoll Ave
Suite 101
Des Moines, IA 50309-3332
Phone (515) 282-4560

1709 N Jefferson Way
Suite 100 Athletico Physical Therapy
Indianola, IA 50125-1459
Phone (515) 962-9272

1850 Sunset Dr
Suite 102
Norwalk, IA 50211-1365
Phone (515) 953-1310

2918 E University Ave
Athletico Physical Therapy
Des Moines, IA 50317-8236
Phone (515) 265-8272

3160 8TH St SW
Suite 1 Athletico Physical Therapy
Altoona, IA 50009-1023
Phone (515) 967-4580

3252 Ridge PT
Bettendorf, IA 52722-5312
Phone (563) 332-4995

452 -454 SE University Ave
Athletico Physical Therapy
Waukee, IA 50263-8121
Phone (515) 987-0465

5045 Bentley Dr
Suite 190
West Des Moines, IA 50265-7010
Phone (515) 226-1616

8000 Douglas Ave
Urbandale, IA 50322-2450
Phone (515) 251-3700

Merit-based Incentive Payment System (MIPS)

Final score
86.32 of 100Reported as group
Quality
84.44
Promoting interoperability
99
Improvement activities
40
Cost
70.78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
004959IAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Athletico LTD Physical Therapist CurrentSince Apr 1, 2019 Accepting new patients
Athletico LTD Physical Therapist CurrentSince Apr 1, 2019 Accepting new patients
Eastern Iowa Therapeutics PC Physical Therapist Past Accepting new patients
Therapy Services of Iowa Inc Physical Therapist Past Accepting new patients

Locations

3252 Ridge Pt
Bettendorf, IA 52722
Phone (563) 332-4995

2918 E University Ave
Des Moines, IA 50317
Phone (515) 265-8272

600 Oakmont Ln
Ste 600C
Westmont, IL 60559
Phone (630) 575-6250

Organizations & group practices 4

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": "1342569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342569600000",
    "number": "1174878938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3209 INGERSOLL AVE",
            "address_2": "SUITE 100",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503123929",
            "telephone_number": "515-282-4560",
            "fax_number": "515-282-4570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3209 INGERSOLL AVE",
            "address_2": "SUITE 100",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503123929",
            "telephone_number": "515-282-4560",
            "fax_number": "515-282-4570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLICK",
        "first_name": "JOELLE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-18",
        "last_updated": "2012-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "004959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.