Active NPI
Advantage Physical Therapy & Rehab, Inc.
- Physical Therapist
- Des Moines, IA
National Provider Identifier
1750691572
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 02018
- Legal business name
- ADVANTAGE PHYSICAL THERAPY & REHAB, INC.
- Practice address
- 7564 Hickman Road
Des Moines, IA 50324-4621 - Phone
- (515) 276-1111
- Fax
- (515) 864-0391
- NPI assigned
- Oct 14, 2010
- Last updated
- May 23, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Charles E Goodhue, MSPT
- Title
- Partner/Physical Therapist
- Phone
- (515) 276-1111
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 02018 | IA | Primary |
Addresses
Primary practice location
7564 Hickman Road
Des Moines, IA 50324-4621
Mailing address
2213 Grand Avenue
Des Moines, IA 50312-5305
Phone (515) 237-3974
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750691572 | Medicaid | IA | |
| DT2836 | Other | IA | RAILROAD MEDICARE |
| 615606502 | Other | OWCP |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 3
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.
-
- Physical Therapist
- Windsor Heights, IA
- NPI 1821285792
-
- Physical Therapist
- Norwalk, IA
- NPI 1225384928
-
- Geriatric Physical Therapist
- Des Moines, IA
- NPI 1760077895
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1287014400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1463961600000",
"number": "1750691572",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2213 GRAND AVENUE",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503125305",
"telephone_number": "515-237-3974",
"fax_number": "515-883-2692"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7564 HICKMAN ROAD",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503244621",
"telephone_number": "515-276-1111",
"fax_number": "515-864-0391"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ADVANTAGE PHYSICAL THERAPY & REHAB, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2010-10-14",
"last_updated": "2016-05-23",
"status": "A",
"authorized_official_last_name": "GOODHUE",
"authorized_official_first_name": "CHARLES",
"authorized_official_middle_name": "E",
"authorized_official_title_or_position": "PARTNER/PHYSICAL THERAPIST",
"authorized_official_telephone_number": "515-276-1111",
"authorized_official_credential": "MSPT"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IA",
"license": "02018",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1750691572",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "DT2836",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OWCP",
"identifier": "615606502",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Des Moines, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.