Rock Valley Physical Therapy Center

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Legal business name

ROCK VALLEY PHYSICAL THERAPY CENTER

Practice address

1225 S Oakwood Ave Ste 1
Geneseo, IL 61254-1990

Phone

(309) 944-6447

NPI assigned

Dec 1, 2021

Last updated

Dec 1, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Randall E BoldtNPI 1043277155

Title

Cfo

Phone

(309) 743-2070

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Rock Valley Physical Therapy Center

  • Physical Therapist
  • Moline, IL
  • NPI 1245373166

  9638087877

  Same PAC ID
• Rock Valley Physical Therapy Center

  • Physical Therapist
  • Clinton, IA
  • NPI 1366724874

  9638087877

  Same PAC ID
• Rock Valley Physical Therapy Center

  • Physical Therapist
  • West Des Moines, IA
  • NPI 1790828457

  9638087877

  Same PAC ID
• Rock Valley Physical Therapy Center

  • Occupational Therapist
  • Eldridge, IA
  • NPI 1881540490

  9638087877

  Same PAC ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Randall E Boldt, PT

  • Physical Therapist
  • Davenport, IA
  • NPI 1043277155
  Authorized official Same address or phone

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

{
    "created_epoch": "1638316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638316800000",
    "number": "1972261535",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 S OAKWOOD AVE STE 1",
            "city": "GENESEO",
            "state": "IL",
            "postal_code": "612541990",
            "telephone_number": "309-944-6447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCK VALLEY PHYSICAL THERAPY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-01",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A",
        "authorized_official_last_name": "BOLDT",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "309-743-2070"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Renee Marie Ramsay
• Bridget Real
• Brockton Reed
• Thomas J Rizzo, DPM
• Amy Roberts
• Rebecca Howard Rode, MS,OTR/L
• Abby Juanita Rodriguez, LMSW
• Jessica Marie Ropp, OTRL
• Nicole Marie Rowold, OTR/L
• Jalyn April Salas

• Occupational Therapist in Geneseo, IL
• Providers in Geneseo, IL by specialty
• Occupational Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2021; 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.