Active NPI
Andrea Redfern, D.P.T
- Physical Therapist
- Guthrie Center, IA
National Provider Identifier
1487069613
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 073977
- Practice address
- 710 N 12TH St
Guthrie Center, IA 50115-1544 - Phone
- (641) 332-3810
- Fax
- (641) 332-3809
- NPI assigned
- Jun 26, 2014
- Last updated
- Mar 4, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 073977 | IA | Primary |
Addresses
Primary practice location
710 N 12TH St
Guthrie Center, IA 50115-1544
Mailing address
710 N 12TH St
Guthrie Center, IA 50115-1544
Phone (641) 332-3810
Other practice location 1
312 N Fremont St Ste B
Stuart, IA 50250-2083
Phone (523) 804-9515
Other names 1
- Andrea Clark
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Critical Access Hospital
- Guthrie Center, IA
- NPI 1366414534
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1403740800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583280000000",
"number": "1487069613",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "710 N 12TH ST",
"city": "GUTHRIE CENTER",
"state": "IA",
"postal_code": "501151544",
"telephone_number": "641-332-3810",
"fax_number": "641-332-3809"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "710 N 12TH ST",
"city": "GUTHRIE CENTER",
"state": "IA",
"postal_code": "501151544",
"telephone_number": "641-332-3810",
"fax_number": "641-332-3809"
}
],
"practiceLocations": [
{
"address_1": "312 N Fremont St Ste B",
"address_purpose": "LOCATION",
"city": "Stuart",
"state": "IA",
"postal_code": "502502083",
"country_code": "US",
"telephone_number": "523-804-9515",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "REDFERN",
"first_name": "ANDREA",
"credential": "D.P.T",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-06-26",
"last_updated": "2020-03-04",
"certification_date": "2020-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IA",
"license": "073977",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ANDREA",
"last_name": "CLARK",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Guthrie Center, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2020; 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.