Rock Valley Physical Therapy Center

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

ROCK VALLEY PHYSICAL THERAPY CENTER

Practice address

112 2ND St NW
Waverly, IA 50677-2619

Phone

(319) 352-0102

Fax

(319) 352-0104

NPI assigned

May 20, 2008

Organization subpart

No

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

Authorized official

Name

Randy E Boldt, P.T.

Title

Cfo

Phone

(309) 743-2070

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1211241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238371200000",
    "number": "1235396912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 43RD AVE",
            "address_2": "SUITE 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": "112 2ND ST NW",
            "city": "WAVERLY",
            "state": "IA",
            "postal_code": "506772619",
            "telephone_number": "319-352-0102",
            "fax_number": "319-352-0104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCK VALLEY PHYSICAL THERAPY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-20",
        "last_updated": "2009-03-30",
        "status": "A",
        "authorized_official_last_name": "BOLDT",
        "authorized_official_first_name": "RANDY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "309-743-2070",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "IA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP BILLING # FOR MEDICAID",
            "identifier": "0565937",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP BILLING # FOR MEDICARE",
            "identifier": "I18344",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca Renze, TLMHC
• Ekaradhika Lila Requena
• Karla Jean Reznicek, LMSW
• Jennifer Renee McCormick Rikkers
• Katherine Jane Marrie Ringo, LPT
• Ron W Roelfs, OD
• Samantha J Rogers, LPT
• Haley Anne Rohret
• Amy Susan Roling, LMHC, NCC
• Jeanne M Rothamel, RN

• Physical Therapist in Waverly, IA
• Providers in Waverly, IA by specialty
• Physical Therapist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2009; 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.