Healthcare Provider Details

I. General information

NPI: 1790618155
Provider Name (Legal Business Name): BRANDI JAE RINGHOLZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1980 NE 84TH STREET SUITE E
CLIVE IA
50325
US

IV. Provider business mailing address

710 NE GEORGETOWN CT
ANKENY IA
50021-9280
US

V. Phone/Fax

Practice location:
  • Phone: 712-250-0990
  • Fax:
Mailing address:
  • Phone: 515-802-2885
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number002063
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: