Kenan Todd
Individual provider Active NPI Physical Therapist · Columbus Junction, IA
NPI 1891385472 · NPPES record last updated Jan 19, 2021
Key facts
- NPI
- 1891385472
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- Practice address
- 104 Main St
Columbus Junction, IA 52738-1028 - Phone
- (319) 728-4441
- NPI assigned
- Jan 19, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Rock Valley Physical Therapy Center
Practice addresses (Care Compare)
104 Main St
Columbus Junction, IA 52738-1028
Phone (319) 728-4441
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210219001669 | IA | Practitioner - Physical Therapist in Private Practice | 1052726296 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rock Valley Physical Therapy Center | Physical Therapist | Current |
Accepting new patients |
| Rock Valley Physical Therapy Center | Physical Therapist | Current |
Accepting new patients |
Locations
104 Main St
Columbus Junction, IA 52738
Phone (319) 728-4441
850 43rd Ave
Ste 100
Moline, IL 61265
Phone (309) 743-2070
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Yes |
Addresses
Primary practice location
104 Main St
Columbus Junction, IA 52738-1028
Mailing address
850 43Rd Ave Ste 100
Moline, IL 61265-8401
Phone (309) 743-2070
Other providers in Columbus Junction, IA
- Hy-Vee Inc
- Brian D Masonholder
- Mercy Services Iowa City, Inc.
- Michael Ted Morrison
- Cory D Nielson
- Town of Columbus JCT.
- Washington County Hospital
- Danielle Kristine Woepking
All providers in Columbus Junction, IA · Physical Therapist in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 19, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.