Individual provider Active NPI

Jane Priebe, P.T.

  • Physical Therapist
  • Independence, IA
National Provider Identifier
1972631968
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
02156 Issued in IA
Practice address
2300 Swan Lake Blvd Ste 103
Independence, IA 50644-9708
Phone
(319) 334-5155
Fax
(319) 334-6166
NPI assigned
Mar 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 02156 IA Primary

Addresses

Primary practice location

2300 Swan Lake Blvd Ste 103
Independence, IA 50644-9708

Mailing address

2300 Swan Lake Blvd Ste 103
Independence, IA 50644-9708
Phone (319) 334-5155

Other identifiers 1

IdentifierTypeStateIssuer
0665745MedicaidIA

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

LicenseStateTypeSpecialty
02156IAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Millennium Rehab & Consulting, Inc. Physical Therapist Past Accepting new patients
Millennium Rehab & Consulting, Inc. Physical Therapist 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.

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1972631968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 SWAN LAKE BLVD STE 103",
            "city": "INDEPENDENCE",
            "state": "IA",
            "postal_code": "506449708",
            "telephone_number": "319-334-5155",
            "fax_number": "319-334-6166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 SWAN LAKE BLVD STE 103",
            "city": "INDEPENDENCE",
            "state": "IA",
            "postal_code": "506449708",
            "telephone_number": "319-334-5155",
            "fax_number": "319-334-6166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIEBE",
        "first_name": "JANE",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-01",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "02156",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0665745",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Independence, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.