Organization Active NPI

Advantage Physical Therapy & Rehab, Inc.

  • Physical Therapist
  • Des Moines, IA
National Provider Identifier
1750691572
Registry record updated May 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
02018 Issued in IA
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, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2016

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
1750691572MedicaidIA
DT2836OtherIARAILROAD MEDICARE
615606502OtherOWCP

National Provider Directory

National Provider Directory

Practitioners & 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.

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.

Verify at the official NPI Registry.