Active NPI
Alex Parker
- Physical Therapist
- Bettendorf, IA
National Provider Identifier
1811545940
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070.024636
- Practice address
- 2805 Stafford Blvd
Bettendorf, IA 52722-3343 - Phone
- (309) 798-1884
- NPI assigned
- Sep 2, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070.024636 | IL | Primary |
Addresses
Primary practice location
2805 Stafford Blvd
Bettendorf, IA 52722-3343
Mailing address
2805 Stafford Blvd
Bettendorf, IA 52722-3343
Phone (309) 798-1884
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070.024636 | IL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1567382400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1567382400000",
"number": "1811545940",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2805 STAFFORD BLVD",
"city": "BETTENDORF",
"state": "IA",
"postal_code": "527223343",
"telephone_number": "309-798-1884"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2805 STAFFORD BLVD",
"city": "BETTENDORF",
"state": "IA",
"postal_code": "527223343",
"telephone_number": "309-798-1884"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARKER",
"first_name": "ALEX",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-09-02",
"last_updated": "2019-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": "IL",
"license": "070.024636",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bettendorf, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.