NPIMap

Organization Active NPI

Rathbun Lake Area Young Mens Christian Association

  • Physical Therapist
  • Centerville, IA
National Provider Identifier
1356619555
Registry record updated May 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
RATHBUN LAKE AREA YOUNG MENS CHRISTIAN ASSOCIATION
Practice address
708 S Main St
Centerville, IA 52544-2422
Phone
(641) 437-1977
Fax
(641) 437-1976
NPI assigned
Dec 2, 2011
Last updated
May 31, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 31, 2012

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

Authorized official

Name
Randy Groff
Title
Executive Director
Phone
(641) 437-1977

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

708 S Main St
Centerville, IA 52544-2422

Mailing address

PO Box 71602
Clive, IA 50325-0602
Phone (515) 243-2057

National Provider Directory

National Provider Directory

Locations

708 S Main St
Centerville, IA 52544
Phone (641) 437-1977

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1322784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338422400000",
    "number": "1356619555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 71602",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503250602",
            "telephone_number": "515-243-2057",
            "fax_number": "515-244-5570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 S MAIN ST",
            "city": "CENTERVILLE",
            "state": "IA",
            "postal_code": "525442422",
            "telephone_number": "641-437-1977",
            "fax_number": "641-437-1976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RATHBUN LAKE AREA YOUNG MENS CHRISTIAN ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-02",
        "last_updated": "2012-05-31",
        "status": "A",
        "authorized_official_last_name": "GROFF",
        "authorized_official_first_name": "RANDY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "641-437-1977"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centerville, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.