NPIMap

Organization Active NPI

On With Life, Inc.

  • Physical Therapist
  • Coralville, IA
National Provider Identifier
1255993655
Registry record updated Jul 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
ON WITH LIFE, INC.
Practice address
2854 Coral Court
Suite 1
Coralville, IA 52241
Phone
(515) 289-9600
NPI assigned
Jul 5, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2019

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) 289-9600

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X

Addresses

Primary practice location

2854 Coral Court
Suite 1
Coralville, IA 52241

Mailing address

715 SW Ankeny Rd
Ankeny, IA 50023-9798

Other names 1

  • On With Life Outpatient Neuro Rehabilitation - Coralville Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Ankeny

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
Practice locations: Ankeny, IA; Coralville, IA

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
On With Life Long Term CarePolk City, IA, CCN 165281 Skilled nursing facility Operational/Managerial Control Jul 1, 2001
On With Life at AnkenyAnkeny, IA, CCN 165163 Skilled nursing facility Operational/Managerial Control May 22, 1987

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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": "1562284800000",
    "number": "1255993655",
    "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"
        },
        {
            "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": "515-289-9600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ON WITH LIFE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-05",
        "last_updated": "2019-07-05",
        "status": "A",
        "authorized_official_last_name": "SHELTON",
        "authorized_official_first_name": "JEAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "515-289-9600"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Ankeny",
            "affiliation": "N",
            "address_1": "2854 Coral Court",
            "address_2": "Suite 1",
            "city": "Coralville",
            "state": "IA",
            "country_code": "US",
            "postal_code": "52241",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "On With Life Outpatient Neuro Rehabilitation - Coralville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Coralville, IA

Sources for this page

Verify at the official NPI Registry.