NPIMap

Organization Active NPI

Providence Therapy Services LLC

  • Rehabilitation Practitioner
  • Clinton, IA
National Provider Identifier
1477808533
Registry record updated Jul 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
License
00085 Issued in IA
Legal business name
PROVIDENCE THERAPY SERVICES LLC
Practice address
2320 N 2ND St
Clinton, IA 52732-2434
Phone
(563) 243-2285
Fax
(563) 243-2293
NPI assigned
Jul 16, 2012
Organization subpart
Yes
Parent organization
PROVIDENCE THERAPY SERVICES LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 30, 2014

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

Authorized official

Name
Gena Hummel
Title
Office Manager - Billing
Phone
(563) 242-1170

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 225400000X 00085 IA Primary

Addresses

Primary practice location

2320 N 2ND St
Clinton, IA 52732-2434

Mailing address

2320 N 2ND St
Clinton, IA 52732-2434
Phone (563) 243-2285

National Provider Directory

National Provider Directory
Part of
Providence Therapy SVCS LLC

Locations

2320 N 2nd St
Clinton, IA 52732
Phone (563) 243-2285

21037 Holden Dr
Davenport, IA 52806
Phone (563) 359-4054

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1342396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406678400000",
    "number": "1477808533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2320 N 2ND ST",
            "city": "CLINTON",
            "state": "IA",
            "postal_code": "527322434",
            "telephone_number": "563-243-2285",
            "fax_number": "563-243-2293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2320 N 2ND ST",
            "city": "CLINTON",
            "state": "IA",
            "postal_code": "527322434",
            "telephone_number": "563-243-2285",
            "fax_number": "563-243-2293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE THERAPY SERVICES LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROVIDENCE THERAPY SERVICES LLC",
        "enumeration_date": "2012-07-16",
        "last_updated": "2014-07-30",
        "status": "A",
        "authorized_official_last_name": "HUMMEL",
        "authorized_official_first_name": "GENA",
        "authorized_official_title_or_position": "OFFICE MANAGER - BILLING",
        "authorized_official_telephone_number": "563-242-1170"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Rehabilitation Practitioner",
            "state": "IA",
            "license": "00085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2014; 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.