Individual provider Active NPI

Amy S Isherwood, D.P.T.

  • Physical Therapist
  • Omaha, NE
National Provider Identifier
1194952564
Registry record updated Nov 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2772 Issued in NE
Practice address
13809 Industrial Rd
Omaha, NE 68137-1117
Phone
(402) 932-7111
Fax
(402) 932-6878
NPI assigned
Jun 12, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2019

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 2772 NE Primary

Addresses

Primary practice location

13809 Industrial Rd
Omaha, NE 68137-1117

Mailing address

13809 Industrial Rd
Omaha, NE 68137-1117
Phone (402) 932-7111

Other practice location 1

1515 South 204th St
Suite 105
Elkhorn, NE 68022-6802
Phone (402) 721-1112

Other practice location 2

13336 Industrial Rd
Suite 105
Omaha, NE 68137-1124
Phone (402) 330-3211 ext. 119

Other identifiers 2

IdentifierTypeStateIssuer
100025381500MedicaidNE
47065477701MedicaidNE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090706000406 NE Practitioner - Physical Therapist in Private Practice 6608927546 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rock Valley Physical Therapy CenterGroup PAC ID 9638087877, 232 clinicians

Practice addresses (Care Compare)

11532 Willow Park Dr
Suite 100
Gretna, NE 68028-6954
Phone (402) 934-2190

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2772NEMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Rock Valley Physical Therapy Center Physical Therapist CurrentSince Oct 1, 2021 Accepting new patients
Rock Valley Physical Therapy Center Physical Therapist CurrentSince Oct 1, 2021 Accepting new patients
Makovicka Harms Group PC Physical Therapist Past Accepting new patients
Procare3, Inc. PastSince Jan 1, 2006 Accepting new patients

Locations

850 43rd Ave
Ste 100
Moline, IL 61265
Phone (309) 743-2070

15767 Hadan Dr
Bennington, NE 68007
Phone (402) 238-2552

1405 N 205th St
Ste 140
Elkhorn, NE 68022
Phone (402) 289-5013

11532 Willow Park Dr
Ste 100
Gretna, NE 68028
Phone (402) 289-5013

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": "1244764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574208000000",
    "number": "1194952564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13809 INDUSTRIAL RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681371117",
            "telephone_number": "402-932-7111",
            "fax_number": "402-932-6878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13809 INDUSTRIAL RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681371117",
            "telephone_number": "402-932-7111",
            "fax_number": "402-932-6878"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1515 South 204th St",
            "address_2": "Suite 105",
            "address_purpose": "LOCATION",
            "city": "Elkhorn",
            "state": "NE",
            "postal_code": "680226802",
            "country_code": "US",
            "telephone_number": "402-721-1112",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13336 Industrial Rd",
            "address_2": "Suite 105",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681371124",
            "country_code": "US",
            "telephone_number": "402-330-3211 x119",
            "fax_number": "402-330-5970",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ISHERWOOD",
        "first_name": "AMY",
        "middle_name": "S",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-12",
        "last_updated": "2019-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "2772",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100025381500",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47065477701",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2019; 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.