Physical and Sports Services PC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

00769 Issued in IA

Legal business name

PHYSICAL AND SPORTS SERVICES PC

Practice address

616 W Platt St
Maquoketa, IA 52060-2118

Phone

(563) 652-4364

NPI assigned

Mar 8, 2018

Organization subpart

No

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

Authorized official

Name

Sheila Pauls

Title

Office Manager

Phone

(563) 652-4364

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Locations

Practitioners 1

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

• Bruce Dale Pauls, PT,MS,ATC

  • Physical Therapist
  • Maquoketa, IA
  • NPI 1922003359
  Medicare reassignment NPD

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

{
    "created_epoch": "1520467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523318400000",
    "number": "1447752142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 W PLATT ST",
            "city": "MAQUOKETA",
            "state": "IA",
            "postal_code": "520602118",
            "telephone_number": "563-652-4364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 W PLATT ST",
            "city": "MAQUOKETA",
            "state": "IA",
            "postal_code": "520602118",
            "telephone_number": "563-652-4364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL AND SPORTS SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-08",
        "last_updated": "2018-04-10",
        "status": "A",
        "authorized_official_last_name": "PAULS",
        "authorized_official_first_name": "SHEILA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "563-652-4364"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "00769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clyde Daniel Overturff, DDS
• Pamela Severson Counseling LLC
• Brent Dale Pauls, D.C.
• Bruce Dale Pauls, PT,MS,ATC
• Eric Scott Petersen, D.O.
• Nicole Powers, NP
• Michelle Ann Prull, RPH
• Robert Taylor Reed, PHARM.D.
• Emily Reiter
• Brandon Beau Rickertsen, D.O.

• Physical Therapist in Maquoketa, IA
• Providers in Maquoketa, IA by specialty
• Physical Therapist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2018; 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.