NPIMap

Organization Active NPI

Eastern Iowa Therapeutics PC

Doing business as Athletico Physical Therapy

  • Physical Therapist
  • Waterloo, IA
National Provider Identifier
1619362902
Registry record updated Oct 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
EASTERN IOWA THERAPEUTICS PC
Doing business as
Athletico Physical Therapy
Practice address
1111 Ansborough Ave
Waterloo, IA 50701-2248
Phone
(319) 433-0130
Fax
(319) 433-0131
NPI assigned
Apr 2, 2015
Last updated
Oct 27, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Geri Cook
Title
Director of Clinical Services
Phone
(630) 575-1940

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X IA Primary

Addresses

Primary practice location

1111 Ansborough Ave
Waterloo, IA 50701-2248

Mailing address

625 Enterprise Dr
Oak Brook, IL 60523-8813
Phone (630) 575-6250

Other names 1

  • Athletico Physical Therapy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Athletico Physical Therapy35 organizations share this tax ID, including this one

Other organizations with this tax ID 34

Organizations that report the same tax identification number in the National Provider Directory.

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1427932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477526400000",
    "number": "1619362902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 ENTERPRISE DR",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605238813",
            "telephone_number": "630-575-6250",
            "fax_number": "630-575-7450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 ANSBOROUGH AVE",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507012248",
            "telephone_number": "319-433-0130",
            "fax_number": "319-433-0131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN IOWA THERAPEUTICS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-02",
        "last_updated": "2016-10-27",
        "status": "A",
        "authorized_official_last_name": "COOK",
        "authorized_official_first_name": "GERI",
        "authorized_official_title_or_position": "DIRECTOR OF CLINICAL SERVICES",
        "authorized_official_telephone_number": "630-575-1940"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Athletico Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waterloo, IA

Sources for this page

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