NPIMap

Organization Active NPI

Physiotherapy Associates Inc

  • Rehabilitation Clinic/Center
  • Cedar Rapids, IA
National Provider Identifier
1750507315
Registry record updated Nov 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
PHYSIOTHERAPY ASSOCIATES INC
Practice address
1220 Jacolyn Dr SW
Cedar Rapids, IA 52404-1288
Phone
(319) 396-0222
Fax
(319) 396-1525
NPI assigned
Apr 18, 2007
Last updated
Nov 12, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2018

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

Authorized official

Name
Michael E. Tarvin
Title
Vice President and Secretary
Phone
(717) 972-1100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X IA Primary

Addresses

Primary practice location

1220 Jacolyn Dr SW
Cedar Rapids, IA 52404-1288

Mailing address

4714 Gettysburg Rd
Mechanicsburg, PA 17055-4325
Phone (717) 972-1100

Other identifiers 1

IdentifierTypeStateIssuer
0665430MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070117000287 IA Part B Supplier - Clinic/Group Practice 3577470442 Receives reassigned benefits from 77 practitioners
25 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: West Des Moines, IA; Ottumwa, IA; Norwalk, IA; Madrid, IA; Johnston, IA; Iowa City, IA; Hiawatha, IA; Des Moines, IA…

Other NPIs on the same Medicare enrollment 25

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

View all 25

National Provider Directory

National Provider Directory

Locations

2455 SW State St
Ste 4
Ankeny, IA 50023
Phone (515) 963-4528

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1541980800000",
    "number": "1750507315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4714 GETTYSBURG RD",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170554325",
            "telephone_number": "717-972-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 JACOLYN DR SW",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524041288",
            "telephone_number": "319-396-0222",
            "fax_number": "319-396-1525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSIOTHERAPY ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-18",
        "last_updated": "2018-11-12",
        "status": "A",
        "authorized_official_last_name": "TARVIN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "VICE PRESIDENT AND SECRETARY",
        "authorized_official_telephone_number": "717-972-1100"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "IA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0665430",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Rapids, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2018; 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.