NPIMap

Organization Active NPI

LTR, LLC

Doing business as Luke Carlson Physical Therapy

  • Physical Therapist
  • Ankeny, IA
National Provider Identifier
1174987614
Registry record updated Nov 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
LTR, LLC
Doing business as
Luke Carlson Physical Therapy
Practice address
110 N Ankeny Blvd Ste 100
Ankeny, IA 50023-1756
Phone
(515) 964-9100
Fax
(515) 964-2700
NPI assigned
Apr 11, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2020

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

Authorized official

Name
Tate Vanhouten, DPT
Title
Owner
Phone
(515) 288-0569

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

110 N Ankeny Blvd Ste 100
Ankeny, IA 50023-1756

Mailing address

110 N Ankeny Blvd Ste 100
Ankeny, IA 50023-1756
Phone (515) 964-9100

Other names 1

  • Luke Carlson 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
O20160606002517 IA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 6103116033 Receives reassigned benefits from 7 practitioners
Practice locations: Ankeny, IA

National Provider Directory

National Provider Directory

Locations

110 N Ankeny Blvd
Ste 100
Ankeny, IA 50023
Phone (515) 964-9100

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1460332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605657600000",
    "number": "1174987614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 N ANKENY BLVD STE 100",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500231756",
            "telephone_number": "515-964-9100",
            "fax_number": "515-964-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 N ANKENY BLVD STE 100",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500231756",
            "telephone_number": "515-964-9100",
            "fax_number": "515-964-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LTR, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-11",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A",
        "authorized_official_last_name": "VANHOUTEN",
        "authorized_official_first_name": "TATE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "515-288-0569",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Luke Carlson Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Luke Carlson Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ankeny, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2020; 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.