Individual provider Active NPI

Debra Ann Poppe, P.T.

  • Physical Therapist
  • Ankeny, IA
National Provider Identifier
1508079849
Registry record updated May 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
01224 Issued in IA
Practice address
2006 S Ankeny Blvd
Building 5
Ankeny, IA 50023-8995
Phone
(515) 289-9541
Fax
(515) 446-3642
NPI assigned
May 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 01224 IA Primary

Addresses

Primary practice location

2006 S Ankeny Blvd
Building 5
Ankeny, IA 50023-8995

Mailing address

1200 Pleasant St
South 2 Room 236
Des Moines, IA 50309-1406
Phone (515) 241-6228

Other names 1

  • Debra Ann Ridenour Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
01224IAMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493856000000",
    "number": "1508079849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 PLEASANT ST",
            "address_2": "SOUTH 2 ROOM 236",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503091406",
            "telephone_number": "515-241-6228",
            "fax_number": "515-241-8685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2006 S ANKENY BLVD",
            "address_2": "BUILDING 5",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500238995",
            "telephone_number": "515-289-9541",
            "fax_number": "515-446-3642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POPPE",
        "first_name": "DEBRA",
        "middle_name": "ANN",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-07",
        "last_updated": "2017-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "01224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBRA",
            "last_name": "RIDENOUR",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ankeny, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 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.