Individual provider Active NPI

Mylah Zaldivar

  • Physical Therapist
  • Pella, IA
National Provider Identifier
1255849717
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
072792 Issued in IA
Practice address
500 Jefferson St
Pella, IA 50219-1255
Phone
(641) 628-6623
Fax
(641) 621-2223
NPI assigned
Jan 18, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 072792 IA Primary

Addresses

Primary practice location

500 Jefferson St
Pella, IA 50219-1255

Mailing address

404 Jefferson St
Pella, IA 50219-1257
Phone (641) 628-6623

Other practice location 1

611 N Hancock St
Ottumwa, IA 52501-4233
Phone (641) 628-6623

Other identifiers 1

IdentifierTypeStateIssuer
072792OtherIAIOWA LICENSE

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
072792IAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1516233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1255849717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 JEFFERSON ST",
            "city": "PELLA",
            "state": "IA",
            "postal_code": "502191257",
            "telephone_number": "641-628-6623",
            "fax_number": "641-621-2223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 JEFFERSON ST",
            "city": "PELLA",
            "state": "IA",
            "postal_code": "502191255",
            "telephone_number": "641-628-6623",
            "fax_number": "641-621-2223"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "611 N Hancock St",
            "address_purpose": "LOCATION",
            "city": "Ottumwa",
            "state": "IA",
            "postal_code": "525014233",
            "country_code": "US",
            "telephone_number": "641-628-6623",
            "fax_number": "641-621-2223",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZALDIVAR",
        "first_name": "MYLAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-18",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "072792",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IOWA LICENSE",
            "identifier": "072792",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pella, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.