Active NPI
Abby Rae Rezansoff
- Physical Therapist
- Ankeny, IA
National Provider Identifier
1508265091
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 082377
- Practice address
- 2006 S Ankeny Blvd
Building 6
Ankeny, IA 50023-8995 - Phone
- (515) 289-9541
- Fax
- (515) 446-3642
- NPI assigned
- Aug 20, 2014
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT4260 | ME | |
| Physical Therapist | 225100000X | 082377 | IA | Primary |
Addresses
Primary practice location
2006 S Ankeny Blvd
Building 6
Ankeny, IA 50023-8995
Mailing address
1200 Pleasant St
South 2 Room 236
Des Moines, IA 50309-1406
Phone (515) 241-6228
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508265091 | Medicaid | IA |
Other names 1
- Abby Rae Bandy
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
| License | State | Type | Specialty |
|---|---|---|---|
| 082377 | IA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Luke's Methodist Hospital | Current | Accepting new patients |
Interoperability endpoints
- arezansoff432784@direct.unitypoint.org
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Acute Care Hospital
- Cedar Rapids, IA
- NPI 1083708226
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1408492800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1493856000000",
"number": "1508265091",
"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 6",
"city": "ANKENY",
"state": "IA",
"postal_code": "500238995",
"telephone_number": "515-289-9541",
"fax_number": "515-446-3642"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REZANSOFF",
"first_name": "ABBY",
"middle_name": "RAE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-08-20",
"last_updated": "2017-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "ME",
"license": "PT4260",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IA",
"license": "082377",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1508265091",
"state": "IA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "ABBY",
"last_name": "BANDY",
"middle_name": "RAE",
"credential": "PT",
"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.