Active NPI
Drew Terence McDonough
- Physical Therapy Clinic/Center
- Coralville, IA
National Provider Identifier
1346948080
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Clinic/Center
- License
- 117931
- Practice address
- 2350 Oakdale Blvd
Coralville, IA 52241-9702 - Phone
- (319) 351-5437
- NPI assigned
- Feb 22, 2023
- Sex
- Male
- Sole proprietor
- Yes
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 Therapy Clinic/Center | 261QP2000X | 117931 | IA | Primary |
Addresses
Primary practice location
2350 Oakdale Blvd
Coralville, IA 52241-9702
Mailing address
5406 Merle Hay Rd
Johnston, IA 50131-1209
Phone (515) 727-8750
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 |
|---|---|---|---|
| 117931 | IA | MD | Physical Therapy Clinic/Center |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Childserve Clinic Inc | Physical Therapy | Past | Accepting new patients |
| Childserve Therapy, Inc. | Physical Therapy | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1677024000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1677024000000",
"number": "1346948080",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5406 MERLE HAY RD",
"city": "JOHNSTON",
"state": "IA",
"postal_code": "501311209",
"telephone_number": "515-727-8750",
"fax_number": "515-727-8757"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2350 OAKDALE BLVD",
"city": "CORALVILLE",
"state": "IA",
"postal_code": "522419702",
"telephone_number": "319-351-5437"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCDONOUGH",
"first_name": "DREW",
"middle_name": "TERENCE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-02-22",
"last_updated": "2023-02-22",
"certification_date": "2023-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "261QP2000X",
"taxonomy_group": "",
"desc": "Clinic/Center, Physical Therapy",
"state": "IA",
"license": "117931",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coralville, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.