Jessica Bettin, DPT
Individual provider Active NPI Physical Therapist · Holstein, IA
NPI 1285009969 · NPPES record last updated Dec 7, 2015
Key facts
- NPI
- 1285009969
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 005323 (IA)
- Practice address
- 505 W 2ND St
Holstein, IA 51025-5111 - Phone
- (712) 368-4304
- NPI assigned
- Dec 7, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240613000874 | IA | Practitioner - Physical Therapist in Private Practice | 2365984747 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 005323 | IA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Blue Stone Therapy Inc. | Current |
Accepting new patients |
Locations
2830 100th St
Ste 100
Urbandale, IA 50322
Phone (515) 537-4770
4319 NW Urbandale Dr
Urbandale, IA 50322
Phone (515) 875-9470
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 005323 | IA | Yes |
Addresses
Primary practice location
505 W 2ND St
Holstein, IA 51025-5111
Mailing address
505 W 2ND St
Holstein, IA 51025-5111
Phone (712) 368-4304
Other providers in Holstein, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 7, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.