Individual provider Active NPI

Jocinda Willer

  • Physical Therapist
  • Mason City, IA
National Provider Identifier
1396989463
Registry record updated Jul 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4242 Issued in IA
Practice address
461 S Illinois Ave
Mason City, IA 50401-4439
Phone
(641) 423-6279
Fax
(641) 423-6707
NPI assigned
Apr 20, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 4242 IA Primary
Physical Therapist 225100000X 11211-024 WI
Physical Therapist 225100000X 070017080 IL

Addresses

Primary practice location

461 S Illinois Ave
Mason City, IA 50401-4439

Mailing address

205 W Wacker Dr
Suite 1020
Chicago, IL 60606-1216
Phone (312) 640-0329

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130912000396 IA Practitioner - Physical Therapist in Private Practice 6204070287 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athletico LTDGroup PAC ID 4789602681, 2,187 clinicians

Practice addresses (Care Compare)

1709 N Jefferson Way
Suite 100 Athletico Physical Therapy
Indianola, IA 50125-1459
Phone (515) 962-9272

3252 Ridge PT
Bettendorf, IA 52722-5312
Phone (563) 332-4995

Merit-based Incentive Payment System (MIPS)

Final score
86.32 of 100Reported as group
Quality
84.44
Promoting interoperability
99
Improvement activities
40
Cost
70.78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4242IAMDPhysical Therapist
070017080ILMDPhysical Therapist
11211-024WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Athletico LTD Physical Therapist CurrentSince Apr 1, 2019 Accepting new patients
Athletico LTD Physical Therapist CurrentSince Apr 1, 2019 Accepting new patients
Athletico LTD Physical Therapist Past Accepting new patients

Locations

3252 Ridge Pt
Bettendorf, IA 52722
Phone (563) 332-4995

2918 E University Ave
Des Moines, IA 50317
Phone (515) 265-8272

461 S Illinois Ave
Mason City, IA 50401
Phone (641) 423-6279

Organizations & group practices 3

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": "1240185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374019200000",
    "number": "1396989463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 W WACKER DR",
            "address_2": "SUITE 1020",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606061216",
            "telephone_number": "312-640-0329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "461 S ILLINOIS AVE",
            "city": "MASON CITY",
            "state": "IA",
            "postal_code": "504014439",
            "telephone_number": "641-423-6279",
            "fax_number": "641-423-6707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLER",
        "first_name": "JOCINDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-20",
        "last_updated": "2013-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "4242",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "11211-024",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070017080",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mason City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2013; 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.

Verify at the official NPI Registry.