Individual provider Active NPI

Kyle A Merten, DPT

  • Physical Therapist
  • Bettendorf, IA
National Provider Identifier
1609149368
Registry record updated Sep 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
004868 Issued in IA
Practice address
2300 53Rd Ave
Suite LL02
Bettendorf, IA 52722-7564
Phone
(563) 449-7000
Fax
(563) 449-7099
NPI assigned
Feb 10, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2014

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 004868 IA Primary

Addresses

Primary practice location

2300 53Rd Ave
Suite LL02
Bettendorf, IA 52722-7564

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
I20120423000107 IA Practitioner - Physical Therapist in Private Practice 0648431486 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rock Valley Physical Therapy CenterGroup PAC ID 9638087877, 232 clinicians

Practice addresses (Care Compare)

3385 Dexter CT
Suite 203
Davenport, IA 52807-3471
Phone (563) 332-9312

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
004868IAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rock Valley Physical Therapy Center Physical Therapist CurrentSince Sep 1, 2014 Accepting new patients
Rock Valley Physical Therapy Center Physical Therapist CurrentSince Sep 1, 2014 Accepting new patients
Ora Orthopedics, PC Past Accepting new patients

Locations

3385 Dexter Ct
Ste 203
Davenport, IA 52807
Phone (563) 332-9312

4451 E 53rd St
Ste 200
Davenport, IA 52807
Phone (563) 362-0016

1414 W Lombard St
Davenport, IA 52804
Phone (563) 326-6431

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": "1328832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409788800000",
    "number": "1609149368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 43RD AVE",
            "address_2": "STE. 100",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612658401",
            "telephone_number": "309-743-2070",
            "fax_number": "309-743-2073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 53RD AVE",
            "address_2": "SUITE LL02",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527227564",
            "telephone_number": "563-449-7000",
            "fax_number": "563-449-7099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERTEN",
        "first_name": "KYLE",
        "middle_name": "A",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-10",
        "last_updated": "2014-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "004868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bettendorf, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2014; 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.