Individual provider Active NPI

Lance Charles Lefurge, PHYSICAL THERAPIST

  • Physical Therapist
  • Ankeny, IA
National Provider Identifier
1679528137
Registry record updated Dec 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4169 Issued in IA
Practice address
1555 SE Delaware Ave
Ankeny, IA 50021-4011
Phone
(515) 963-8723
Fax
(515) 963-8755
NPI assigned
May 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 4926 CO
Physical Therapist 225100000X 4169 IA Primary

Addresses

Primary practice location

1555 SE Delaware Ave
Ankeny, IA 50021-4011

Mailing address

1555 SE Delaware Ave
Ankeny, IA 50021-4011
Phone (515) 963-8723

Other identifiers 1

IdentifierTypeStateIssuer
P00606786OtherIARR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080521000436 IA Practitioner - Physical Therapist in Private Practice 8123197829 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physiotherapy Associates IncGroup PAC ID 3577470442, 1,432 clinicians

Practice addresses (Care Compare)

1450 SW Vintage Pkwy
Ankeny, IA 50023-7165
Phone (515) 416-8600

5900 NW 86TH St
Suite 200
Johnston, IA 50131-2284
Phone (515) 278-8151

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4926COMDPhysical Therapist
4169IAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physiotherapy Associates Inc CurrentSince Jun 7, 2024 Accepting new patients
Physiotherapy Associates Inc Current Accepting new patients
Des Moines University Osteopathic Medical Center Physical Therapist Past Accepting new patients

Locations

710 E 1st St
Ankeny, IA 50021
Phone (515) 963-8723

1555 S 1st Ave
Iowa City, IA 52240
Phone (319) 248-6800

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449100800000",
    "number": "1679528137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 SE DELAWARE AVE",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500214011",
            "telephone_number": "515-963-8723",
            "fax_number": "515-963-8755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 SE DELAWARE AVE",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500214011",
            "telephone_number": "515-963-8723",
            "fax_number": "515-963-8755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEFURGE",
        "first_name": "LANCE",
        "middle_name": "CHARLES",
        "name_prefix": "Mr.",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-23",
        "last_updated": "2015-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "4926",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "4169",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00606786",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ankeny, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.