Individual provider Active NPI

Rob F Hentzen, PT, MBA

  • Physical Therapist
  • Des Moines, IA
National Provider Identifier
1225239858
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
131372 Issued in IA
Practice address
4725 Merle Hay Rd
Suite 107
Des Moines, IA 50322-1983
Phone
(515) 331-3190
Fax
(515) 331-3191
NPI assigned
May 30, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 131372 IA Primary

Addresses

Primary practice location

4725 Merle Hay Rd
Suite 107
Des Moines, IA 50322-1983

Mailing address

1065 Browns Woods Dr
West Des Moines, IA 50265-8360
Phone (515) 331-3190

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Business Administration

State licenses

LicenseStateTypeSpecialty
131372IAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225239858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1065 BROWNS WOODS DR",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502658360",
            "telephone_number": "515-331-3190",
            "fax_number": "515-331-3191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4725 MERLE HAY RD",
            "address_2": "SUITE 107",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503221983",
            "telephone_number": "515-331-3190",
            "fax_number": "515-331-3191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENTZEN",
        "first_name": "ROB",
        "middle_name": "F",
        "name_prefix": "Mr.",
        "credential": "PT, MBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "131372",
            "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 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.