Active NPI
Michael R Edgington, PT, DPT
- Physical Therapist
- Ankeny, IA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 130679
- Practice address
- 301 N Ankeny Blvd
Ankeny, IA 50023-1730 - Phone
- (800) 974-4378
- Fax
- (630) 515-1536
- NPI assigned
- Jun 10, 2016
- Last updated
- Mar 17, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | CP042791T | NE | |
| Physical Therapist | 225100000X | 12277 | AZ | |
| Physical Therapist | 225100000X | 130679 | IA | Primary |
Addresses
Primary practice location
301 N Ankeny Blvd
Ankeny, IA 50023-1730
Mailing address
24014 W Renwick Rd Unit 206
Plainfield, IL 60544-8711
Phone (800) 974-4378
Other practice location 1
410 E 22nd St Ste 2
Fremont, NE 68025-2640
Phone (800) 974-4378 ext. 2074
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NE
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250327002604 | NE | Practitioner - Physical Therapist in Private Practice | 4183910870 |
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2016
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
24014 W Renwick Rd
Unit 206
Plainfield, IL 60544-8711
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12277 | AZ | MD | Physical Therapist |
| 130679 | IA | MD | Physical Therapist |
| CP042791T | NE | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DPT Holdings, LLC | Physical Therapist | Current | Accepting new patients |
Locations
6213 S Miller Rd
Ste 103
Buckeye, AZ 85326
Phone (623) 386-2660
950 E Riggs Rd
Ste 1
Chandler, AZ 85249
Phone (480) 802-8730
403 W Central Ave
Coolidge, AZ 85128
Phone (520) 424-2222
3050 N Litchfield Rd
Ste 100
Goodyear, AZ 85395
Phone (623) 935-0626
21300 N John Wayne Pkwy
Ste 107
Maricopa, AZ 85139
Phone (480) 899-9829
4530 E Shea Blvd
Ste 105
Phoenix, AZ 85028
Phone (480) 494-2050
301 N Ankeny Blvd
Ste 200
Ankeny, IA 50023
Phone (515) 965-1422
24014 W Renwick Rd
Ste 206
Plainfield, IL 60544
410 E 22nd St
Ste 2
Fremont, NE 68025
Phone 8009744378 ext. 2074
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465516800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1742169600000",
"number": "1376992297",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24014 W RENWICK RD UNIT 206",
"city": "PLAINFIELD",
"state": "IL",
"postal_code": "605448711",
"telephone_number": "800-974-4378",
"fax_number": "630-515-1536"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 N ANKENY BLVD",
"city": "ANKENY",
"state": "IA",
"postal_code": "500231730",
"telephone_number": "800-974-4378",
"fax_number": "630-515-1536"
}
],
"practiceLocations": [
{
"address_1": "410 E 22nd St Ste 2",
"address_purpose": "LOCATION",
"city": "Fremont",
"state": "NE",
"postal_code": "680252640",
"country_code": "US",
"telephone_number": "800-974-4378 x2074",
"fax_number": "630-515-1536",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "EDGINGTON",
"first_name": "MICHAEL",
"middle_name": "R",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-06-10",
"last_updated": "2025-03-17",
"certification_date": "2025-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NE",
"license": "CP042791T",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AZ",
"license": "12277",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IA",
"license": "130679",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Ankeny, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.