21ST CENTURY REHAB,PC (NPI# 1174783583) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174783583 |
| Entity Type | Organization |
| Organization Name | 21ST CENTURY REHAB,PC |
| Other Organization Name | INDIANOLA PHYSICAL THERAPY |
| Practice Address |
1507 N 1st St Indianola IA 50125-3703 |
| Mailing Address |
Po Box 461 Nevada IA 50201-0461 |
| Practice Telephone | 5159617435 |
| Practice Fax Number | 5159617436 |
| Mailing Telephone | 5153823366 |
| Mailing Fax Number | 5153821576 |
| Enumeration Date | 2008-06-10 |
| Last Update Date | 2008-07-17 |
| Authorized Official Name | MICHELLE R CASSABAUM (CFO) |
| Authorized Official Telephone | 5153823366 |
| Is Organization Subpart | Y |
| Parent Organization Name | 21ST CENTURY REHAB, PC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0400X |
Clinic/Center Specialization: Rehabilitation |
IA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | WELLMARK BCBS | 36587 | 01 |
| IA | 0665810 | 05 |
| Other Name | Type Code |
|---|---|
| Indianola Physical Therapy | Doing Business As Name - Organization |
| Street Address |
1507 N 1ST ST |
| City | INDIANOLA |
| State | IA |
| Zip Code | 50125-3703 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538114764 | Sue Marie Peterson | Specialist/Technologist | 1507 N 1st St, Indianola, IA 50125 | 2006-05-24 |
| 1073036091 | Jessica L Nelson | Physical Therapist | 1507 N 1st St, Indianola, IA 50125-3703 | 2017-07-21 |
| 1376975326 | Eric Michael Holton | Physical Therapist | 1507 N 1st St, Indianola, IA 50125-3703 | 2013-08-01 |
| 1992137947 | Natalie Rielle Theroux | Physical Therapist | 1507 N 1st St, Indianola, IA 50125-3703 | 2013-08-01 |
| 1255671392 | Austin Douglas Ollinger | Physical Therapy Assistant | 1507 N 1st St, Indianola, IA 50125-3703 | 2013-02-27 |
| 1881902245 | Nicole Anne Pontier | Specialist/Technologist | 1507 N 1st St, Indianola, IA 50125-3703 | 2010-09-20 |
| 1134303605 | Diane E Dewall | Occupational Therapist | 1507 N 1st St, Indianola, IA 50125-3703 | 2007-12-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316583107 | Mach3 Physical Therapy and Wellness | Clinic/Center | 938 East Hillcrest Ave, Suite A, Indianola, IA 50125 | 2019-11-27 |
| 1023667995 | Bonnie Dufault | Technician | 2402 West Euclid Ave, Indiana, IA 50125 | 2019-09-04 |
| 1407307499 | Traci Rudolf-hanrahan | Social Worker | 310 North Buxton Street, Indianola, IA 50125 | 2016-10-14 |
| 1548544216 | Long Term Medical Supply Corp | Durable Medical Equipment & Medical Supplies | 126 N Howard St, Suite 102, Indianola, IA 50125 | 2011-09-29 |
| 1629272836 | Michael James Hadden | Specialist/Technologist | Simpson College, 701 North C Street, Indianola, IA 50125 | 2007-06-12 |
| 1245440221 | Indianola Ia Assisted Living | Assisted Living Facility | 608 South 15th St., Indianola, IA 50125 | 2007-05-22 |
| 1689769432 | Michele Tingle | Emergency Medicine | 9128 87th Ln, Indianola, IA 50125 | 2006-10-04 |
| 1124079934 | Jonathan P Anderson | Optometrist | 225 W Ashland, Ste 1, Indianola, IA 50125 | 2006-05-15 |
| 1528025533 | Jessica A Espenmiller | Occupational Therapist | 1507 North 1st St, Indianola, IA 50125 | 2006-04-26 |
| 1619947199 | City of Indianola | Ambulance | 110 N First, Indianola, IA 50125 | 2006-01-25 |
| Find all providers in zip 50125 | ||||
| Taxonomy Code | 261QR0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285233064 | Physiotherapy Associates, Inc. | Clinic/Center | 998 Westdale Parkway, Cedar Rapids, IA 52404 | 2020-10-22 |
| 1053924449 | Pella Regional Health Center | Clinic/Center | 404 S Commerce, Prairie City, IA 50228-8560 | 2020-08-26 |
| 1730702275 | Physiotherapy Associates, Inc. | Clinic/Center | 87 Paine St Se Ste 1&2, Bondurant, IA 50035-1451 | 2020-05-19 |
| 1821617069 | Physiotherapy Assoicates, Inc. | Clinic/Center | 319 7th St Ste 102, Des Moines, IA 50309-3812 | 2020-04-08 |
| 1194354795 | Physiotherapy Assoicates, Inc. | Clinic/Center | 87 Paine St Se, Bondurant, IA 50035-1451 | 2020-04-06 |
| 1245892629 | On With Life, Inc | Clinic/Center | 2854 Coral Court, Suite 1, Coralville, IA 52241 | 2019-07-05 |
| 1982265559 | Physiotherapy Associates, Inc. | Clinic/Center | 516 Nile Kinnick Dr S Ste B, Adel, IA 50003-2076 | 2019-06-25 |
| 1548820145 | Physiotherapy Associates, Inc. | Clinic/Center | 1327 Sunset Dr # 400, Norwalk, IA 50211-1343 | 2019-06-17 |
| 1952822801 | Physiotherapy Assoicates, Inc. | Clinic/Center | 9500 University Ave Ste 1115, West Des Moines, IA 50266-1745 | 2017-06-30 |
| 1659746766 | Physiotherapy Associates Inc | Clinic/Center | 3111 Gordon Dr, Sioux City, IA 51105-3730 | 2015-12-01 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.