Ryan Waack, PT, D.P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

085705 Issued in IA

Practice address

100 Alexander Dr.
Ste. 4
Tipton, IA 52772

Phone

(563) 886-3421

Fax

(563) 886-2083

NPI assigned

Feb 6, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Progressive Rehabilitation Associates L.L.C.

  • Physical Therapist
  • Iowa City, IA
  • NPI 1851462865

  IA, Physical Therapist

  Medicare reassignment NPD
• Premier Physical Therapy of Iowa

  • Physical Therapist
  • Burlington, IA
  • NPI 1477325132
  NPD

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

{
    "created_epoch": "1486339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682985600000",
    "number": "1740728153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 S. SCOTT BLVD.",
            "address_2": "STE. 1",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "52240",
            "telephone_number": "319-354-2429",
            "fax_number": "319-338-5775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 ALEXANDER DR.",
            "address_2": "STE. 4",
            "city": "TIPTON",
            "state": "IA",
            "postal_code": "52772",
            "telephone_number": "563-886-3421",
            "fax_number": "563-886-2083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAACK",
        "first_name": "RYAN",
        "credential": "PT, D.P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-06",
        "last_updated": "2023-05-02",
        "certification_date": "2023-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "085705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tipton Adaptive Daycare LLC
• Tipton Community School
• Su Hsin Liao Tung
• Van Den Berghe Chiropractic LLC
• Deborah Lorraine Vandergaast, RN
• Walmart Inc.
• Cynthia Weber
• Lindsey Anne Willey, PAC
• Marlon Emil Williams Sr.
• Angela Kay Hunt Wolf, MS, PHARMD, RPH

• All providers in Tipton, IA
• Physical Therapist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2023; 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.