Active NPI
Janelle McCalla, PT
- Physical Therapist
- Waverly, IA
National Provider Identifier
1861463291
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 02079
- Practice address
- 112 2ND St NW
Waverly, IA 50677-2619 - Phone
- (319) 352-0102
- Fax
- (319) 352-0104
- NPI assigned
- Feb 1, 2006
- 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 | 02079 | IA | Primary |
Addresses
Primary practice location
112 2ND St NW
Waverly, IA 50677-2619
Mailing address
850 43Rd Ave Ste 100
Moline, IL 61265-8401
Phone (309) 743-2070
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02079 | Other | IA | IOWA PHYSICAL THERAPY LICENSE |
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 |
|---|---|---|---|
| 02079 | IA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138752000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1334188800000",
"number": "1861463291",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "850 43RD AVE STE 100",
"city": "MOLINE",
"state": "IL",
"postal_code": "612658401",
"telephone_number": "309-743-2070",
"fax_number": "309-743-2073"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "112 2ND ST NW",
"city": "WAVERLY",
"state": "IA",
"postal_code": "506772619",
"telephone_number": "319-352-0102",
"fax_number": "319-352-0104"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCALLA",
"first_name": "JANELLE",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-01",
"last_updated": "2012-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IA",
"license": "02079",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IOWA PHYSICAL THERAPY LICENSE",
"identifier": "02079",
"state": "IA"
}
],
"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 Apr 12, 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.