NPIMap

Organization Active NPI

Proactive Physical Therapy & Sports Rehab, Inc

  • Physical Therapist
  • Sioux Center, IA
National Provider Identifier
1487773602
Registry record updated Sep 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PROACTIVE PHYSICAL THERAPY & SPORTS REHAB, INC
Practice address
110 16TH St SW
Sioux Center, IA 51250-2944
Phone
(712) 722-1902
Fax
(712) 722-1905
NPI assigned
Mar 28, 2007
Last updated
Sep 24, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2015

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

Authorized official

Name
Julie Arends, MPTNPI 1396878310
Title
Co-Owner
Phone
(712) 722-1902

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

110 16TH St SW
Sioux Center, IA 51250-2944

Mailing address

110 16TH St NW
Sioux Center, IA 51250-1535
Phone (712) 722-1902

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150107001238 IA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 4587762406 Receives reassigned benefits from 10 practitioners
Practice locations: Rock Valley, IA; Sheldon, IA; Sibley, IA; Sioux Center, IA

National Provider Directory

National Provider Directory
Tax ID family
Proactive Physical Therapy and Sports Rehab2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1518 14th St
Ste A
Rock Valley, IA 51247
Phone (712) 470-9898

301 10th St
Ste C
Sheldon, IA 51201
Phone (712) 324-0110

322 9th St
Sibley, IA 51249
Phone (712) 720-7664

1031 13th Ave NE
Sioux Center, IA 51250
Phone (712) 722-2981

110 16th St SW
Sioux Center, IA 51250
Phone (712) 722-1902

147 S Main Ave
Sioux Center, IA 51250
Phone (712) 363-7779

Practitioners & affiliated clinicians

Practitioners 13

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 13

NPI Registry JSON

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443052800000",
    "number": "1487773602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 16TH ST NW",
            "city": "SIOUX CENTER",
            "state": "IA",
            "postal_code": "512501535",
            "telephone_number": "712-722-1902",
            "fax_number": "712-722-1905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 16TH ST SW",
            "city": "SIOUX CENTER",
            "state": "IA",
            "postal_code": "512502944",
            "telephone_number": "712-722-1902",
            "fax_number": "712-722-1905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROACTIVE PHYSICAL THERAPY & SPORTS REHAB, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2015-09-24",
        "status": "A",
        "authorized_official_last_name": "ARENDS",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "712-722-1902",
        "authorized_official_credential": "MPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Center, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2015; 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.