Kayla Goedken, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

004364 Issued in IA

Practice address

217 E Bremer Ave
Waverly, IA 50677-3435

Phone

(800) 268-7192

NPI assigned

Mar 30, 2021

Last updated

Mar 30, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Fox Rehab PT Ia PLLC

  • Physical Therapist
  • Norwalk, IA
  • NPI 1730840240
  Medicare reassignment NPD

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

{
    "created_epoch": "1617062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1497333710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2090 PASADENA DR APT 3",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520010814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 E BREMER AVE",
            "city": "WAVERLY",
            "state": "IA",
            "postal_code": "506773435",
            "telephone_number": "800-268-7192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOEDKEN",
        "first_name": "KAYLA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-30",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "004364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Regan Renae Gerstenkorn, MA, CCC-SLP
• Amanda Joan Gesme, LMHC, ATR-BC, NCC
• Jason L Gipson, MD
• Sadie Shae Glynn
• Jada Goddard, TCADC
• Christopher James Goetzinger, MD
• Kristen Grapp, ARNP
• Stephanie Marie Grieger, PT
• H Mark Trunnell DDS PC
• Tanya Haase, SLP

• Physical Therapist in Waverly, IA
• Providers in Waverly, IA by specialty
• Physical Therapist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2021; 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.