NPIMap

Organization Active NPI

Sioux City Physical Therapy PC

  • Physical Therapist
  • Sioux City, IA
National Provider Identifier
1346313996
Registry record updated May 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
SIOUX CITY PHYSICAL THERAPY PC
Practice address
2802 Castles Gate Dr
Sioux City, IA 51106-7203
Phone
(712) 266-0707
Fax
(712) 266-0709
NPI assigned
Nov 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2023

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

Authorized official

Name
Stephen Leo Venne, P.T.NPI 1831278571
Title
Owner
Phone
(712) 266-0707

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X

Addresses

Primary practice location

2802 Castles Gate Dr
Sioux City, IA 51106-7203

Mailing address

2802 Castles Gate Dr
Sioux City, IA 51106-7203
Phone (712) 266-0707

Other identifiers 2

IdentifierTypeStateIssuer
36936OtherIABCBS GROUP NUMBER
0488767MedicaidIA

Other names 1

  • Sioux City Physical Therapy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160505000966 IA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 8628060084 Receives reassigned benefits from 2 practitioners
Practice locations: Sioux City, IA

National Provider Directory

National Provider Directory

Locations

520 4th St SW
Ste A
Le Mars, IA 51031
Phone (712) 546-4222

2802 Castles Gate Dr
Sioux City, IA 51106
Phone (712) 266-0707

3250 Plaza Dr
South Sioux City, NE 68776
Phone (402) 412-4220

Practitioners & affiliated clinicians

Practitioners 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683676800000",
    "number": "1346313996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2802 CASTLES GATE DR",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511067203",
            "telephone_number": "712-266-0707",
            "fax_number": "712-266-0709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2802 CASTLES GATE DR",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511067203",
            "telephone_number": "712-266-0707",
            "fax_number": "712-266-0709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIOUX CITY PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2023-05-10",
        "certification_date": "2023-05-10",
        "status": "A",
        "authorized_official_last_name": "VENNE",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "LEO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "712-266-0707",
        "authorized_official_credential": "P.T."
    },
    "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
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP NUMBER",
            "identifier": "36936",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0488767",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sioux City Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sioux City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2023; 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.