Active NPI
Kayla Reeg
- Physical Therapist
- Waverly, IA
National Provider Identifier
1821503616
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- CP022487T
- Practice address
- 1922 5TH Ave NW
Waverly, IA 50677-1903 - Phone
- (319) 352-4540
- NPI assigned
- Dec 4, 2017
- Sex
- Female
- Sole proprietor
- No
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 | CP022487T | IA | Primary |
Addresses
Primary practice location
1922 5TH Ave NW
Waverly, IA 50677-1903
Mailing address
2406 Lake Ridge Dr
Fort Wayne, IN 46804-3822
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CP022487T | IA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1512345600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689552000000",
"number": "1821503616",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2406 LAKE RIDGE DR",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468043822"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1922 5TH AVE NW",
"city": "WAVERLY",
"state": "IA",
"postal_code": "506771903",
"telephone_number": "319-352-4540"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REEG",
"first_name": "KAYLA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-12-04",
"last_updated": "2023-07-17",
"certification_date": "2023-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IA",
"license": "CP022487T",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waverly, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.