NPIMap

Organization Active NPI

Childserve Therapy, Inc.

  • Physical Therapist
  • Johnston, IA
National Provider Identifier
1679614754
Registry record updated Sep 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
CHILDSERVE THERAPY, INC.
Practice address
5406 Merle Hay Rd
Johnston, IA 50131-1209
Phone
(515) 727-8750
Fax
(515) 727-8757
NPI assigned
Feb 9, 2007
Last updated
Sep 10, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
CHILDSERVE INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 10, 2020

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

Authorized official

Name
Jennifer Pavlovec
Title
Director of Finance
Phone
(515) 727-1463

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 224Z00000X
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary
Pediatric Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251P0200X IA
Physical Therapy AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 225200000X IA
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X IA
Pediatric Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225XP0200X IA
AudiologistGroup: 193200000X MULTI-SPECIALTY GROUP 231H00000X IA
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X

Addresses

Primary practice location

5406 Merle Hay Rd
Johnston, IA 50131-1209

Mailing address

PO Box 707
Johnston, IA 50131-0707
Phone (515) 727-8750

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040323000786 IA Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 7618868282 Practice locations: Ames, IA; Coralville, IA; Des Moines, IA; Hiawatha, IA; Johnston, IA
O20040406000057 IA Part B Supplier - Clinic/Group Practice 7618868282 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
Practice locations: Ames, IA; Johnston, IA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Childserve Audiology4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

1915 Philadelphia St
Ames, IA 50010
Phone (515) 232-7220

644 24th St
Des Moines, IA 50312
Phone (515) 280-5332

1661 Boyson Square Dr
Ste 100
Hiawatha, IA 52233
Phone (319) 221-7376

5406 Merle Hay Rd
Ste 1
Johnston, IA 50131

607 Myatt Dr
Maquoketa, IA 52060
Phone (563) 241-4230

Practitioners & affiliated clinicians

Practitioners 160

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.

View all 160

NPI Registry JSON

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599696000000",
    "number": "1679614754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 707",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501310707",
            "telephone_number": "515-727-8750",
            "fax_number": "515-727-8757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5406 MERLE HAY RD",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501311209",
            "telephone_number": "515-727-8750",
            "fax_number": "515-727-8757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDSERVE THERAPY, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHILDSERVE INC.",
        "enumeration_date": "2007-02-09",
        "last_updated": "2020-09-10",
        "certification_date": "2020-09-10",
        "status": "A",
        "authorized_official_last_name": "PAVLOVEC",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "515-727-1463"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapy Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Pediatrics",
            "state": "IA",
            "license": null,
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapy Assistant",
            "state": "IA",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "IA",
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "IA",
            "license": null,
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Audiologist",
            "state": "IA",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnston, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2020; 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.