Individual provider Active NPI

Audrey Hentges, DPT, ATC/L

  • Physical Therapist
  • Cedar Rapids, IA
National Provider Identifier
1619330693
Registry record updated Mar 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
078011 Issued in IA
Practice address
487 Country Hill Cir NE Apt 1
Cedar Rapids, IA 52402-8304
Phone
(563) 543-5115
NPI assigned
Mar 29, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2016

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 078011 IA Primary

Addresses

Primary practice location

487 Country Hill Cir NE Apt 1
Cedar Rapids, IA 52402-8304

Mailing address

487 Country Hill Cir NE Apt 1
Cedar Rapids, IA 52402-8304
Phone (563) 543-5115

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
078011IAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1459209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459209600000",
    "number": "1619330693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "487 COUNTRY HILL CIR NE APT 1",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524028304",
            "telephone_number": "563-543-5115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "487 COUNTRY HILL CIR NE APT 1",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524028304",
            "telephone_number": "563-543-5115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENTGES",
        "first_name": "AUDREY",
        "credential": "DPT, ATC/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-29",
        "last_updated": "2016-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "078011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Rapids, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2016; 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.