Savannah Renee Fuelberth, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

117347 Issued in IA

Practice address

2769 Heartland Dr Ste 301
Coralville, IA 52241-2732

Phone

(319) 545-4121

Fax

(319) 545-4128

NPI assigned

Feb 6, 2023

Sex

Female

Sole proprietor

No

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.

• Progressive Rehabilitation Associates L.L.C.

  • Physical Therapist
  • Iowa City, IA
  • NPI 1851462865

  IA, Physical Therapist

  Medicare reassignment NPD
• Premier Physical Therapy of Iowa

  • Physical Therapist
  • Burlington, IA
  • NPI 1477325132
  NPD

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

• Savannah Renee Wiedow Former name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 6, 2023.

{
    "created_epoch": "1675641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675641600000",
    "number": "1649976176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 S SCOTT BLVD STE 1",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522402909",
            "telephone_number": "319-354-2429",
            "fax_number": "319-338-5775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2769 HEARTLAND DR STE 301",
            "city": "CORALVILLE",
            "state": "IA",
            "postal_code": "522412732",
            "telephone_number": "319-545-4121",
            "fax_number": "319-545-4128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUELBERTH",
        "first_name": "SAVANNAH",
        "middle_name": "RENEE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-06",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "117347",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06-65463",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAVANNAH",
            "last_name": "WIEDOW",
            "middle_name": "RENEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• CHI Forchu, PHARMD
• Julia Alison Foster, M.S.
• Anna Freeman, LMSW
• Lauren Freeman
• Ann Froeschle
• Olivia Fuller, RN
• Andrew Gallo, PT
• Hannah Marie Gardner, ATC, BA
• Kathryn Gardner
• Kirk Kendal Garmager, M.D.

• All providers in Coralville, IA
• Physical Therapist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.