Individual provider Active NPI

Andrea Renee Schwab Roe, LPT

  • Physical Therapist
  • Waverly, IA
National Provider Identifier
1619274255
Registry record updated Feb 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
03211 Issued in IA
Practice address
1810 4TH St SW
Suite 103a
Waverly, IA 50677-4389
Phone
(319) 352-6400
Fax
(319) 352-4655
NPI assigned
Feb 17, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2011

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 03211 IA Primary

Addresses

Primary practice location

1810 4TH St SW
Suite 103a
Waverly, IA 50677-4389

Mailing address

PO Box 2660
Waterloo, IA 50704-2660
Phone (319) 233-3044

Other names 1

  • Andrea Renee Schwab Former name

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

LicenseStateTypeSpecialty
03211IAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1297900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297900800000",
    "number": "1619274255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2660",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507042660",
            "telephone_number": "319-233-3044",
            "fax_number": "319-233-0722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 4TH ST SW",
            "address_2": "SUITE 103A",
            "city": "WAVERLY",
            "state": "IA",
            "postal_code": "506774389",
            "telephone_number": "319-352-6400",
            "fax_number": "319-352-4655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHWAB ROE",
        "first_name": "ANDREA",
        "middle_name": "RENEE",
        "credential": "LPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-02-17",
        "last_updated": "2011-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "03211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "SCHWAB",
            "middle_name": "RENEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Waverly, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2011; 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.