NPIMap

Organization Active NPI

Sportsplus Sports Medicine and Physical Therapy Center Inc

  • Physical Therapy Clinic/Center
  • Marshalltown, IA
National Provider Identifier
1467422014
Registry record updated Dec 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
SPORTSPLUS SPORTS MEDICINE AND PHYSICAL THERAPY CENTER INC
Practice address
32 E Main St
Marshalltown, IA 50158-4903
Phone
(641) 753-6636
Fax
(641) 753-1005
NPI assigned
Jan 25, 2006
Last updated
Dec 5, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2018

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

Authorized official

Name
Megan Gonzalez
Title
Business Office Manager
Phone
(641) 753-6636

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary
Rehabilitation Clinic/Center 261QR0400X

Addresses

Primary practice location

32 E Main St
Marshalltown, IA 50158-4903

Mailing address

32 E Main St
Marshalltown, IA 50158-4903
Phone (641) 753-6636

Other identifiers 2

IdentifierTypeStateIssuer
49081OtherIABLUE CROSS BLUE SHIELD
0257121MedicaidIA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040331001692 IA Part B Supplier - Clinic/Group Practice 1759373699 Receives reassigned benefits from 3 practitioners
Practice locations: Marshalltown, IA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 21

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.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543968000000",
    "number": "1467422014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 E MAIN ST",
            "city": "MARSHALLTOWN",
            "state": "IA",
            "postal_code": "501584903",
            "telephone_number": "641-753-6636",
            "fax_number": "641-753-1005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 E MAIN ST",
            "city": "MARSHALLTOWN",
            "state": "IA",
            "postal_code": "501584903",
            "telephone_number": "641-753-6636",
            "fax_number": "641-753-1005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTSPLUS SPORTS MEDICINE AND PHYSICAL THERAPY CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-25",
        "last_updated": "2018-12-05",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "MEGAN",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "641-753-6636"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "49081",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0257121",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marshalltown, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 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.