Individual provider Active NPI

Erich Winfield Ottervanger, PT, DPT

  • Physical Therapist
  • West Des Moines, IA
National Provider Identifier
1578882213
Registry record updated Jan 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
3701 Ep True Pkwy
Suite 300
West Des Moines, IA 50265-7696
Phone
(515) 480-8038
NPI assigned
May 20, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2024

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 Primary

Addresses

Primary practice location

3701 Ep True Pkwy
Suite 300
West Des Moines, IA 50265-7696

Mailing address

850 43Rd Ave Ste 100
Moline, IL 61265-8401
Phone (309) 743-2070

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100908000607 IA Practitioner - Physical Therapist in Private Practice 2163547555 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5700 University Ave
Suite 222
West Des Moines, IA 50266-8276
Phone (309) 743-2070

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rock Valley Physical Therapy Center Physical Therapist CurrentSince Jan 10, 2024 Accepting new patients
Rock Valley Physical Therapy Center Physical Therapist CurrentSince Jan 10, 2024 Accepting new patients
Eastern Iowa Therapeutics PC Physical Therapist Past Accepting new patients

Locations

3701 Ep True Pkwy
Ste 300
West Des Moines, IA 50265
Phone (515) 224-6761

5700 University Ave
Ste 222
West Des Moines, IA 50266
Phone (309) 743-2070

850 43rd Ave
Ste 100
Moline, IL 61265
Phone (309) 743-2070

Organizations & group practices 3

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": "1274313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1578882213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 43RD AVE STE 100",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612658401",
            "telephone_number": "309-743-2070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 EP TRUE PKWY",
            "address_2": "SUITE 300",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502657696",
            "telephone_number": "515-480-8038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTERVANGER",
        "first_name": "ERICH",
        "middle_name": "WINFIELD",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-20",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.