Sprout Pediatric Therapy Services

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

001958 Issued in IA

Legal business name

SPROUT PEDIATRIC THERAPY SERVICES

Practice address

3498 450TH St
Orange City, IA 51041-7506

Phone

(712) 737-9065

Fax

(712) 737-9064

NPI assigned

Jul 11, 2016

Organization subpart

No

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

Authorized official

Name

Elizabeth Ann Van Bruggen, MS IN OT

Title

Owner

Phone

(712) 441-1710

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Rachel Kay Meyer, OTD/L

  • Occupational Therapist
  • Cherokee, IA
  • NPI 1699267534
  NPD (past)

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

{
    "created_epoch": "1468195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1496620800000",
    "number": "1487006706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4244 CHESTNUT AVE",
            "city": "HAWARDEN",
            "state": "IA",
            "postal_code": "510237406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3498 450TH ST",
            "city": "ORANGE CITY",
            "state": "IA",
            "postal_code": "510417506",
            "telephone_number": "712-737-9065",
            "fax_number": "712-737-9064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPROUT PEDIATRIC THERAPY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-11",
        "last_updated": "2017-06-05",
        "status": "A",
        "authorized_official_last_name": "VAN BRUGGEN",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "712-441-1710",
        "authorized_official_credential": "MS IN OT"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "IA",
            "license": "001958",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0170200",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julieta Silva
• Kimberly Simkins, ARNP
• Emily Bryna Smith
• Lisa J. Smith, LMSW
• Heather M Spaan, LMSW
• Randall Paul Stange, DC
• Malia Steffl
• Neenah Stinson
• Kallie Annmarie Stromenger, PA-S
• Krayton Struve, DDS

• All providers in Orange City, IA
• Occupational Therapist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2017; 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.