Active NPI
Blake Engelhoven, PTA
- Physical Therapy Assistant
- Des Moines, IA
National Provider Identifier
1851845689
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 083012
- Practice address
- 450 Laurel St.
Des Moines, IA 50314 - Phone
- (515) 323-6485
- NPI assigned
- Aug 10, 2016
- Sex
- Male
- 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 Therapy Assistant | 225200000X | 083012 | IA | Primary |
Addresses
Primary practice location
450 Laurel St.
Des Moines, IA 50314
Mailing address
248 52ND St.
Unit 94
West Des Moines, IA 50265-2878
Phone (641) 660-9044
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 |
|---|---|---|---|
| 083012 | IA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1470787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1470787200000",
"number": "1851845689",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "248 52ND ST.",
"address_2": "UNIT 94",
"city": "WEST DES MOINES",
"state": "IA",
"postal_code": "502652878",
"telephone_number": "641-660-9044"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "450 LAUREL ST.",
"city": "DES MOINES",
"state": "IA",
"postal_code": "50314",
"telephone_number": "515-323-6485"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENGELHOVEN",
"first_name": "BLAKE",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-08-10",
"last_updated": "2016-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "IA",
"license": "083012",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Des Moines, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.