Active NPI
Jamie Blum
- Physical Therapy Assistant
- Storm Lake, IA
National Provider Identifier
1922437771
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 001410
- Practice address
- 315 W 5TH St
Storm Lake, IA 50588-1743 - Phone
- (712) 732-7724
- Fax
- (712) 732-1275
- NPI assigned
- Nov 2, 2013
- 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 Therapy Assistant | 225200000X | 001410 | IA | Primary |
Addresses
Primary practice location
315 W 5TH St
Storm Lake, IA 50588-1743
Mailing address
315 W 5TH St
Storm Lake, IA 50588-1743
Phone (712) 732-7724
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001410 | IA | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sports Rehab & Professional Therapy Associates | Past | Accepting new patients | |
| Sports Rehab and Professional Therapy Associates Inc | Physical Therapy Assistant | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Customized Equipment (DME)
- Storm Lake, IA
- NPI 1285772970
-
- Rehabilitation Clinic/Center
- Storm Lake, IA
- NPI 1033289749
Physical Therapy Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1383350400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1383350400000",
"number": "1922437771",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "315 W 5TH ST",
"city": "STORM LAKE",
"state": "IA",
"postal_code": "505881743",
"telephone_number": "712-732-7724",
"fax_number": "712-732-1275"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "315 W 5TH ST",
"city": "STORM LAKE",
"state": "IA",
"postal_code": "505881743",
"telephone_number": "712-732-7724",
"fax_number": "712-732-1275"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLUM",
"first_name": "JAMIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-11-02",
"last_updated": "2013-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "IA",
"license": "001410",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Storm Lake, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.