Individual provider Active NPI

Emily K Glynn, DPT

  • Physical Therapist
  • Davenport, IA
National Provider Identifier
1568595122
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
04018 Issued in IA
Practice address
3385 Dexter CT
Suite 203
Davenport, IA 52807-3471
Phone
(563) 332-9312
Fax
(563) 332-9316
NPI assigned
Mar 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 04018 IA Primary

Addresses

Primary practice location

3385 Dexter CT
Suite 203
Davenport, IA 52807-3471

Mailing address

6146 Dodds Dr
Bettendorf, IA 52722-6545
Phone (563) 332-0626

Other identifiers 3

IdentifierTypeStateIssuer
04018OtherIAIOWA PT LICENSE NUMBER
0565937MedicaidIA
1245373166OtherILGROUP NPI NUMBER

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rock Valley Physical Therapy Center Physical Therapist PastSince Sep 26, 2008 Accepting new patients
Rock Valley Physical Therapy Center Physical Therapist Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1568595122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6146 DODDS DR",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527226545",
            "telephone_number": "563-332-0626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3385 DEXTER CT",
            "address_2": "SUITE 203",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528073471",
            "telephone_number": "563-332-9312",
            "fax_number": "563-332-9316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLYNN",
        "first_name": "EMILY",
        "middle_name": "K",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-13",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "04018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IOWA PT LICENSE NUMBER",
            "identifier": "04018",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0565937",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI NUMBER",
            "identifier": "1245373166",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.

Verify at the official NPI Registry.