NPIMap

Organization Active NPI

Eastern Iowa Physical Therapy PC

  • Physical Therapist
  • Wilton, IA
National Provider Identifier
1790870566
Registry record updated Apr 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
EASTERN IOWA PHYSICAL THERAPY PC
Practice address
400 Ovesen Drive
Wilton, IA 52778-9612
Phone
(563) 732-4317
NPI assigned
Oct 4, 2006
Last updated
Apr 13, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2012

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

Authorized official

Name
Ms. Beth Ann Dessner, PT
Title
Owner
Phone
(563) 732-4317

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

400 Ovesen Drive
Wilton, IA 52778-9612

Mailing address

400 Ovesen Dr
PO Box 688
Wilton, IA 52778-9612
Phone (563) 732-4317

Other identifiers 1

IdentifierTypeStateIssuer
0434340MedicaidIA

National Provider Directory

National Provider Directory

Locations

107 5th St
Durant, IA 52747
Phone (563) 785-6022

2109 Cedarwood Dr
Ste 100
Muscatine, IA 52761
Phone (563) 288-6787

Practitioners & affiliated clinicians

Practitioners 9

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": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334275200000",
    "number": "1790870566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 OVESEN DR",
            "address_2": "PO BOX 688",
            "city": "WILTON",
            "state": "IA",
            "postal_code": "527789612",
            "telephone_number": "563-732-4317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 OVESEN DRIVE",
            "city": "WILTON",
            "state": "IA",
            "postal_code": "527789612",
            "telephone_number": "563-732-4317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN IOWA PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2012-04-13",
        "status": "A",
        "authorized_official_last_name": "DESSNER",
        "authorized_official_first_name": "BETH",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "563-732-4317",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0434340",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilton, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2012; 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.