Individual provider Active NPI

Mary K Allen

  • Physical Therapist
  • Hiawatha, IA
National Provider Identifier
1710071758
Registry record updated Mar 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
03196 Issued in IA
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

Updated by the provider on Mar 10, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
0665430MedicaidIA

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

LicenseStateTypeSpecialty
03196IAMDPhysical 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.

Verify at the official NPI Registry.