Active NPI
Jordan R Deneve, DPT
- Physical Therapist
- Bettendorf, IA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 072794
- Practice address
- 2300 53Rd Ave Ste LL02
Bettendorf, IA 52722-7565 - Phone
- (563) 449-7000
- NPI assigned
- Feb 26, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070020563 | IL | |
| Physical Therapist | 225100000X | 072794 | IA | Primary |
Addresses
Primary practice location
2300 53Rd Ave Ste LL02
Bettendorf, IA 52722-7565
Mailing address
850 43Rd Ave Ste 100
Moline, IL 61265-8401
Phone (309) 743-2070
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 072794 | Other | IA | PT LICENSE |
Other names 1
- Jordan R Galles
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL, IA
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3385 Dexter CT
Suite 203
Davenport, IA 52807-3471
Phone (563) 332-9312
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 072794 | IA | MD | Physical Therapist |
| 070020563 | IL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rock Valley Physical Therapy Center | Physical Therapist | Current | Accepting new patients |
| Rock Valley Physical Therapy Center | Physical Therapist | Current | Accepting new patients |
| Ora Orthopedics, PC | Past | Accepting new patients |
Locations
931 13th Ave N
Clinton, IA 52732
Phone (563) 242-2305
3385 Dexter Ct
Ste 203
Davenport, IA 52807
Phone (563) 332-9312
520 Valley View Dr
Moline, IL 61265
Phone (309) 762-1952
850 43rd Ave
Ste 100
Moline, IL 61265
Phone (309) 743-2070
850 43rd Ave
Ste 300
Moline, IL 61265
Phone (309) 743-0300
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.
-
- Orthopaedic Surgery Physician
- Moline, IL
- NPI 1962481861
-
- Occupational Therapist
- Eldridge, IA
- NPI 1881540490
Physical Therapist
-
- Orthopaedic Surgery Physician
- Durant, IA
- NPI 1639159700
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1393372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617148800000",
"number": "1194140244",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "850 43RD AVE STE 100",
"city": "MOLINE",
"state": "IL",
"postal_code": "612658401",
"telephone_number": "309-743-2070",
"fax_number": "309-743-2073"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2300 53RD AVE STE LL02",
"city": "BETTENDORF",
"state": "IA",
"postal_code": "527227565",
"telephone_number": "563-449-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DENEVE",
"first_name": "JORDAN",
"middle_name": "R",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-02-26",
"last_updated": "2021-03-31",
"certification_date": "2021-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070020563",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IA",
"license": "072794",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PT LICENSE",
"identifier": "072794",
"state": "IA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JORDAN",
"last_name": "GALLES",
"middle_name": "R",
"credential": "DPT",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Bettendorf, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2021; 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.