Active NPI
Timothy James Lundberg, DPT
- Physical Therapist
- Urbandale, IA
National Provider Identifier
1568572964
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 03718
- Practice address
- 15931 Hammontree Dr
Urbandale, IA 50323-2260 - Phone
- (515) 987-1428
- NPI assigned
- Aug 30, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 | 03718 | IA | Primary |
Addresses
Primary practice location
15931 Hammontree Dr
Urbandale, IA 50323-2260
Mailing address
15931 Hammontree Dr
Urbandale, IA 50323-2260
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03718 | IA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1568572964",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15931 HAMMONTREE DR",
"city": "URBANDALE",
"state": "IA",
"postal_code": "503232260"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15931 HAMMONTREE DR",
"city": "URBANDALE",
"state": "IA",
"postal_code": "503232260",
"telephone_number": "515-987-1428"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUNDBERG",
"first_name": "TIMOTHY",
"middle_name": "JAMES",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IA",
"license": "03718",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Urbandale, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.