Individual provider Active NPI

Gretchen Sara Crum, PT, DPT

  • Physical Therapist
  • Council Bluffs, IA
National Provider Identifier
1881424943
Registry record updated Aug 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
126224 Issued in IA
Practice address
1260 Valley View Dr
Council Bluffs, IA 51503-5245
Phone
(402) 609-3580
NPI assigned
Aug 5, 2024
Last updated
Aug 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 4635 NE
Physical Therapist 225100000X 126224 IA Primary

Addresses

Primary practice location

1260 Valley View Dr
Council Bluffs, IA 51503-5245

Mailing address

1260 Valley View Dr
Council Bluffs, IA 51503-5245
Phone (402) 609-3580

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241104002997 IA Practitioner - Physical Therapist in Private Practice 7911430566 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Nebraska College of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthowest, LLCGroup PAC ID 8921086893, 109 clinicians

Practice addresses (Care Compare)

1260 Valley View Dr
Council Bluffs, IA 51503-5245
Phone (402) 609-3000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4635NEMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthowest LLC CurrentSince Aug 29, 2024 Accepting new patients
Orthowest LLC Physical Therapist CurrentSince Aug 29, 2024 Accepting new patients

Locations

933 E Pierce St
Council Bluffs, IA 51503
Phone (712) 328-6000

2725 S 144th St
Ste 212
Omaha, NE 68144
Phone (402) 354-4000

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1722816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1881424943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1260 VALLEY VIEW DR",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515035245",
            "telephone_number": "402-609-3580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1260 VALLEY VIEW DR",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515035245",
            "telephone_number": "402-609-3580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUM",
        "first_name": "GRETCHEN",
        "middle_name": "SARA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-05",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "4635",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "126224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Council Bluffs, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.