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

Last updated

May 12, 2014By the provider in NPPES

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, MDNPI 1033197165

Title

President

Phone

(319) 234-0109

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Farid Frederick Manshadi, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Waterloo, IA
  • NPI 1033197165
  Authorized official Same address or phone

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.