Active NPI
Mary K Allen
- Physical Therapist
- Hiawatha, IA
National Provider Identifier
1710071758
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 03196
- Practice address
- 2166 Blairs Ferry Rd
Hiawatha, IA 52233-7902 - Phone
- (319) 395-6000
- Fax
- (319) 395-6015
- NPI assigned
- Oct 3, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 03196 | IA | Primary |
Addresses
Primary practice location
2166 Blairs Ferry Rd
Hiawatha, IA 52233-7902
Mailing address
4700 Tama St SE
Ste 700
Cedar Rapids, IA 52403-4556
Phone (319) 447-0700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0665430 | Medicaid | IA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03196 | IA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1236643200000",
"number": "1710071758",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4700 TAMA ST SE",
"address_2": "STE 700",
"city": "CEDAR RAPIDS",
"state": "IA",
"postal_code": "524034556",
"telephone_number": "319-447-0700",
"fax_number": "319-447-0808"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2166 BLAIRS FERRY RD",
"city": "HIAWATHA",
"state": "IA",
"postal_code": "522337902",
"telephone_number": "319-395-6000",
"fax_number": "319-395-6015"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALLEN",
"first_name": "MARY",
"middle_name": "K",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-03",
"last_updated": "2009-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IA",
"license": "03196",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0665430",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Hiawatha, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.