Joel Ingram
Individual provider Active NPI Physical Therapist · Cresco, IA
NPI 1831607019 · NPPES record last updated Mar 13, 2025
Key facts
- NPI
- 1831607019
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- Practice address
- 235 8TH Ave W
Cresco, IA 52136-1062 - Phone
- (563) 547-6361
- NPI assigned
- Jan 22, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Stadia Sports Medicine PC
Practice addresses (Care Compare)
7601 Office Plaza Dr N
Suite 140
West Des Moines, IA 50266-1207
Phone (515) 221-1102
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in IA, MN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180607002116 | IA | Practitioner - Physical Therapist in Private Practice | 0446515704 | Reassigns benefits to 2 organizations |
| I20240126004051 | MN | Practitioner - Physical Therapist in Private Practice | 0446515704 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13372 | MN | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Activept Corp | Current |
Accepting new patients | |
| Stadia Sports Medicine PC | Physical Therapist | Current |
Accepting new patients |
| Ora Orthopedics, PC | Past | Accepting new patients | |
| Pursuitpt LLC | Physical Therapist | Past |
Accepting new patients |
Locations
7601 Office Plaza Dr N
Ste 140
West Des Moines, IA 50266
6000 University Ave
West Des Moines, IA 50266
Phone (515) 241-2100
6000 University Ave
Ste 250
West Des Moines, IA 50266
Phone (515) 221-1102
3100 19th St NW
Ste 200
Rochester, MN 55901
4229 W Frontage Rd N
Rochester, MN 55901
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Yes |
Addresses
Primary practice location
235 8TH Ave W
Cresco, IA 52136-1062
Mailing address
850 43Rd Ave Ste 100
Moline, IL 61265-8401
Phone (309) 743-2070
Other providers in Cresco, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 13, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.