Physical Medicine & Rehabilitation Associates of Northeast Iowa Inc

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

27493 Issued in IA

Legal business name

PHYSICAL MEDICINE & REHABILITATION ASSOCIATES OF NORTHEAST IOWA INC

Practice address

36 W Park Lane
Waterloo, IA 50701-5178

Phone

(319) 234-0109

Fax

(319) 234-5774

NPI assigned

Aug 22, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Farid F Manshadi, MD

Title

President

Phone

(319) 234-0109

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1187740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399852800000",
    "number": "1659564664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 W PARK LN",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507015178",
            "telephone_number": "319-234-0109",
            "fax_number": "319-234-5774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 W PARK LANE",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507015178",
            "telephone_number": "319-234-0109",
            "fax_number": "319-234-5774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL MEDICINE & REHABILITATION ASSOCIATES OF NORTHEAST IOWA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-22",
        "last_updated": "2014-05-12",
        "status": "A",
        "authorized_official_last_name": "MANSHADI",
        "authorized_official_first_name": "FARID",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "319-234-0109",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IA",
            "license": "27493",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "J-054600",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaden Peterson
• Taylor Noelle Peterson, LMSW
• Jamie Petrie
• Thomas Paul Petrie, D.O.
• Kate Phillips
• Physical Therapy Partners
• Amber Pierce, MT-BC
• Kelli Jo Pierce, ARNP
• Jessica Ellen Pifkin, ARNP
• Wesley Charles Pilkington, PHARMD

• Physical Medicine & Rehabilitation Physician in Waterloo, IA
• Providers in Waterloo, IA by specialty
• Physical Medicine & Rehabilitation Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2014; 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.