NPIMap

Organization Active NPI

Rock Valley Physical Therapy Center

  • Physical Therapist
  • Clinton, IA
National Provider Identifier
1780966614
Registry record updated Sep 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
ROCK VALLEY PHYSICAL THERAPY CENTER
Practice address
2635 Lincoln Way
Suite C
Clinton, IA 52732-7203
Phone
(563) 243-8321
Fax
(563) 241-4353
NPI assigned
Sep 16, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2011

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

Authorized official

Name
Randy E Boldt, PT
Title
Cfo
Phone
(309) 743-2070

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X

Addresses

Primary practice location

2635 Lincoln Way
Suite C
Clinton, IA 52732-7203

Mailing address

850 43Rd Ave
Suite 100
Moline, IL 61265-8401
Phone (309) 743-2070

Other identifiers 2

IdentifierTypeStateIssuer
0565937MedicaidIA
I1844OtherIAMEDICARE PTAN

National Provider Directory

National Provider Directory
Tax ID family
Rock Valley PT Center6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1316131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316131200000",
    "number": "1780966614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 43RD AVE",
            "address_2": "SUITE 100",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612658401",
            "telephone_number": "309-743-2070",
            "fax_number": "309-743-2073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2635 LINCOLN WAY",
            "address_2": "SUITE C",
            "city": "CLINTON",
            "state": "IA",
            "postal_code": "527327203",
            "telephone_number": "563-243-8321",
            "fax_number": "563-241-4353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCK VALLEY PHYSICAL THERAPY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-16",
        "last_updated": "2011-09-16",
        "status": "A",
        "authorized_official_last_name": "BOLDT",
        "authorized_official_first_name": "RANDY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "309-743-2070",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0565937",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "I1844",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2011; 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.