Mitchell Blythe, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070-020731 Issued in IL

Practice address

850 43Rd Ave Ste 300
Moline, IL 61265-8401

Phone

(309) 743-0300

Fax

(309) 743-0318

NPI assigned

Jun 23, 2014

Last updated

Jul 18, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Total Rehab-Orthopedic and Sports Specialist, P.C.

  • Physical Therapist
  • Grinnell, IA
  • NPI 1700986304
  Medicare reassignment NPD
• Total Rehab-Orthopedic & Sports Specialists, P.C.

  • Physical Therapy Clinic/Center
  • Williamsburg, IA
  • NPI 1174875199
  NPD

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

{
    "created_epoch": "1403481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405641600000",
    "number": "1891100426",
    "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": "850 43RD AVE STE 300",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612658401",
            "telephone_number": "309-743-0300",
            "fax_number": "309-743-0318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLYTHE",
        "first_name": "MITCHELL",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-23",
        "last_updated": "2014-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "073981",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070-020731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Bleeker, COTA/L
• Blew Family Dentistry
• Blew Family Dentistry, P.C.
• Bryan Christopher Blew, D.D.S.
• Robert E Blew, DDS
• Steven A Boardman, M.D.
• Dawn M Bode, MD
• Denise Diane Boelens, ACNP
• Saysha M. Bolden, AGACNP-BC
• Lindsey Bollaert, APN

• Physical Therapist in Moline, IL
• Providers in Moline, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.