Individual provider Active NPI

Amy Ann Entrekin, PT

  • Physical Therapist
  • Johnston, IA
National Provider Identifier
1609016823
Registry record updated Feb 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
03440 Issued in IA
Practice address
5623 NW 86TH St
Suite 400
Johnston, IA 50131-2956
Phone
(515) 270-0303
Fax
(515) 270-0160
NPI assigned
Feb 27, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2009

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 03440 IA Primary

Addresses

Primary practice location

5623 NW 86TH St
Suite 400
Johnston, IA 50131-2956

Mailing address

2213 Grand Ave
Des Moines, IA 50312-5305
Phone (515) 237-3974

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050913001024 IA Practitioner - Physical Therapist in Private Practice 8224061080 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bartek Therapy Services, Inc.Group PAC ID 7113906447, 13 clinicians

Practice addresses (Care Compare)

5627 NW 86TH St
Suite 200
Johnston, IA 50131-1738
Phone (515) 270-0303

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
03440IAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bartek Therapy Services, Inc. Physical Therapist CurrentSince Feb 25, 2010 Accepting new patients

Locations

1810 SW White Birch Cir
Ste 107
Ankeny, IA 50023
Phone (515) 882-2429

5627 NW 86th St
Ste 200
Johnston, IA 50131
Phone (515) 270-0303

5623 NW 86th St
Ste 400
Johnston, IA 50131
Phone (515) 270-0303

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.

NPI Registry JSON

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

{
    "created_epoch": "1235692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235692800000",
    "number": "1609016823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2213 GRAND AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503125305",
            "telephone_number": "515-237-3974",
            "fax_number": "515-883-2692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5623 NW 86TH ST",
            "address_2": "SUITE 400",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501312956",
            "telephone_number": "515-270-0303",
            "fax_number": "515-270-0160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENTREKIN",
        "first_name": "AMY",
        "middle_name": "ANN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-27",
        "last_updated": "2009-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "03440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnston, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2009; 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.