Active NPI
Karen Ely, PT
- Physical Therapist
- Clive, IA
National Provider Identifier
1871601518
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 00297
- Practice address
- 1601 NW 114TH St
Suite 155
Clive, IA 50325 - Phone
- (515) 222-7350
- Fax
- (515) 222-7350
- NPI assigned
- Aug 25, 2006
- Last updated
- Apr 15, 2009
- 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 | 00297 | IA | Primary |
Addresses
Primary practice location
1601 NW 114TH St
Suite 155
Clive, IA 50325
Mailing address
PO Box 1475
Des Moines, IA 50305-1475
Phone (515) 222-7350
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3430850 | Medicaid | IA |
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 |
|---|---|---|---|
| 00297 | IA | MD | Audiologist-Hearing Aid Fitter |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156464000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1239753600000",
"number": "1871601518",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1475",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503051475",
"telephone_number": "515-222-7350",
"fax_number": "515-222-7355"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1601 NW 114TH ST",
"address_2": "SUITE 155",
"city": "CLIVE",
"state": "IA",
"postal_code": "50325",
"telephone_number": "515-222-7350",
"fax_number": "515-222-7350"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELY",
"first_name": "KAREN",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-25",
"last_updated": "2009-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IA",
"license": "00297",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3430850",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Clive, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.