Individual provider Active NPI

Lauren Michelle Plum, P.T.

  • Physical Therapist
  • Des Moines, IA
National Provider Identifier
1174892954
Registry record updated Jun 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
415300056 Issued in IA
Practice address
3200 Grand Ave
Des Moines, IA 50312-4104
Phone
(515) 271-1717
NPI assigned
Dec 22, 2011
Last updated
Jun 9, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2022

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 004870 IA
Physical Therapist 225100000X 415300056 IA Primary

Addresses

Primary practice location

3200 Grand Ave
Des Moines, IA 50312-4104

Mailing address

3200 Grand Ave
Des Moines, IA 50312-4104
Phone (515) 271-1717

Other identifiers 1

IdentifierTypeStateIssuer
0665463MedicaidIA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241011000751 NE Practitioner - Physical Therapist in Private Practice 2769893460 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Iowa, RJ & L Carver College of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Creighton UniversityGroup PAC ID 4284527508, 11 clinicians

Practice addresses (Care Compare)

17055 Frances St
Suite 100
Omaha, NE 68130-4655
Phone (402) 280-3555

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
415300056IAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Creighton University Physical Therapist CurrentSince Aug 1, 2024 Accepting new patients
Progressive Rehabilitation Associates L.L.C. Physical Therapist Past Accepting new patients
Creighton University Past Accepting new patients
Progressive Rehab Chiropractic, L.L.C. Past Accepting new patients

Locations

3006 Webster St
Omaha, NE 68131
Phone (402) 280-3555

17055 Frances St
Ste 100
Omaha, NE 68130
Phone (402) 280-3555

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1324512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654732800000",
    "number": "1174892954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 GRAND AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503124104",
            "telephone_number": "515-271-1717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 GRAND AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503124104",
            "telephone_number": "515-271-1717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLUM",
        "first_name": "LAUREN",
        "middle_name": "MICHELLE",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-22",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "004870",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "415300056",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0665463",
            "state": "IA"
        }
    ],
    "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 Jun 9, 2022; 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.