Active NPI
Rachel Lee Goedken, D.P.T.
- Physical Therapist
- Ottumwa, IA
National Provider Identifier
1295919926
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 03967
- Practice address
- 1001 Pennsylvania Ave
Ottumwa, IA 52501-6427 - Phone
- (641) 684-2440
- NPI assigned
- Dec 17, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 03967 | IA | Primary |
Addresses
Primary practice location
1001 Pennsylvania Ave
Ottumwa, IA 52501-6427
Mailing address
418 E Manning Ave
Ottumwa, IA 52501-1332
Phone (515) 249-7002
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03967 | IA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1197849600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1197849600000",
"number": "1295919926",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "418 E MANNING AVE",
"city": "OTTUMWA",
"state": "IA",
"postal_code": "525011332",
"telephone_number": "515-249-7002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 PENNSYLVANIA AVE",
"city": "OTTUMWA",
"state": "IA",
"postal_code": "525016427",
"telephone_number": "641-684-2440"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOEDKEN",
"first_name": "RACHEL",
"middle_name": "LEE",
"credential": "D.P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-12-17",
"last_updated": "2007-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IA",
"license": "03967",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ottumwa, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.