Tara Renee' McMullen, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

004484 Issued in IA

Practice address

2010 E Ridgeway Ave
Waterloo, IA 50702-2730

Phone

(319) 233-3010

Fax

(319) 233-3909

NPI assigned

Feb 17, 2010

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• US PT Physical Therapy Limited Partnership

  • Physical Therapist
  • Waterloo, IA
  • NPI 1497858658
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1266364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266364800000",
    "number": "1861714933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 E RIDGEWAY AVE",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507022730",
            "telephone_number": "319-233-3010",
            "fax_number": "319-233-3909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 E RIDGEWAY AVE",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507022730",
            "telephone_number": "319-233-3010",
            "fax_number": "319-233-3909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMULLEN",
        "first_name": "TARA",
        "middle_name": "RENEE'",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-17",
        "last_updated": "2010-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "004484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel P McGrane, MPT
• Shayla McIntyre, PT, DPT, CLT-LANA
• Cole McKenzie, RPH
• Neil G McMahon, MD
• Marie McMillen, DO
• Kathleen McNamara
• Michelle Lee McPoland, LMSW
• Kathleen Medd, ARNP
• Kathleen A Megivern, DO
• Prachi Mehmi, MD

• Physical Therapist in Waterloo, IA
• Providers in Waterloo, IA by specialty
• Physical Therapist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.