NPIMap

Organization Active NPI

On With Life, Inc

Doing business as On With Life Outpatient Neuro Rehabilitation

  • Rehabilitation Clinic/Center
  • Coralville, IA
National Provider Identifier
1245892629
Registry record updated Mar 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
ON WITH LIFE, INC
Doing business as
On With Life Outpatient Neuro Rehabilitation
Practice address
2854 Coral Court
Suite 1
Coralville, IA 52241
Phone
(515) 289-9703
NPI assigned
Jul 5, 2019
Last updated
Mar 4, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2021

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

Authorized official

Name
Jean Shelton
Title
Ceo
Phone
(515) 289-9703

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X NU Primary

Addresses

Primary practice location

2854 Coral Court
Suite 1
Coralville, IA 52241

Mailing address

715 SW Ankeny Rd
Ankeny, IA 50023-9798
Phone (515) 289-9703

Other names 1

  • On With Life Outpatient Neuro Rehabilitation Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Ankeny On With Life, Inc.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20181019001088 IA Part B Supplier - Clinic/Group Practice 4385553965 Receives reassigned benefits from 18 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Ankeny, IA; Coralville, IA
O20191227001376 IA Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 4385553965 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Ankeny, IA; Coralville, IA

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
On With Life Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2854 Coral Ct
Ste 1
Coralville, IA 52241
Phone (319) 259-6224

404 N 5th St
Red Oak, IA 51566
Phone (712) 527-2689

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1562284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614816000000",
    "number": "1245892629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 SW ANKENY RD",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500239798",
            "telephone_number": "515-289-9703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2854 CORAL COURT",
            "address_2": "SUITE 1",
            "city": "CORALVILLE",
            "state": "IA",
            "postal_code": "52241",
            "telephone_number": "515-289-9703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ON WITH LIFE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-05",
        "last_updated": "2021-03-04",
        "certification_date": "2021-03-04",
        "status": "A",
        "authorized_official_last_name": "SHELTON",
        "authorized_official_first_name": "JEAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "515-289-9703"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Ankeny",
            "affiliation": "Y",
            "affiliationName": "On With Life, Inc.",
            "address_1": "715 SW Ankeny Rd",
            "city": "Ankeny",
            "state": "IA",
            "country_code": "US",
            "postal_code": "500235999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "On With Life Outpatient Neuro Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Coralville, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2021; 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.