Childserve Therapy, Inc.
Organization Active NPI Physical Therapist · Johnston, IA
NPI 1679614754 · NPPES record last updated Sep 10, 2020
Key facts
- NPI
- 1679614754
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 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
- Organization subpart
- Yes
- Parent organization (as reported)
- CHILDSERVE INC.
Authorized official
- Name
- Jennifer Pavlovec
- Title
- Director of Finance
- Phone
- (515) 727-1463
Other NPIs on the same Medicare enrollment 1
Corporate family (same tax ID) 3
Practitioners 157
-
Carin A Bejarno, ARNP
-
Jennifer A Groos, MD
-
Laura Elizabeth Moeller, M.D.
-
Elaina Mae Abrams, PT, DPT
-
Julia Anderson, OTR/L
-
Zoe N Angus, MA, CF-SLP
-
Dana Bailey, PT, DPT
-
Heather Nicole Baird, CF-SLP
-
Summer Renee Barber, OTD, OTR-L
-
Breanne Lynn Bebb, MOTR/L
-
Carol Hart Boeke, MS, CCC-SLP
-
Molly Ann Boell, OT
-
Jessica Kay Cartee, OTD, OTR/L
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in IA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
- Tax ID family
- Childserve Audiology
Locations
644 24th St
Des Moines, IA 50312
Phone (515) 280-5332
1661 Boyson Square Dr
Ste 100
Hiawatha, IA 52233
Phone (319) 221-7376
2350 Oakdale Blvd
Iowa City, IA 52241
Phone (319) 351-5437
5406 Merle Hay Rd
Ste 1
Johnston, IA 50131
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant |
224Z00000X | |||
| Physical Therapist |
225100000X | Yes | ||
| Pediatric Physical Therapist |
2251P0200X | IA | ||
| Physical Therapy Assistant |
225200000X | IA | ||
| Occupational Therapist |
225X00000X | IA | ||
| Pediatric Occupational Therapist |
225XP0200X | IA | ||
| Audiologist |
231H00000X | IA | ||
| Speech-Language Pathologist |
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
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0665091 | Medicaid | IA | |
| 65443 | Other | IA | COVENTY |
| 110061 | Other | IA | HEALTH ALLIANCE |
| 0120113 | Medicaid | IA | |
| 640002508 | Other | IA | RAILROAD MEDICARE |
| F245447 | Other | IA | MIDLAND'S CHOICE |
| 66509 | Other | IA | BCBS OF IOWA |
Other providers in Johnston, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 10, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.