MEDICARE: MILLENNIUM REHAB & CONSULTING, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	224Z00000X	Occupational Therapy Assistant	00441	IA
2	225100000X	Physical Therapist	02666	IA
3	225100000X	Physical Therapist	02594	IA
4	225100000X	Physical Therapist	03694	IA
5	225100000X	Physical Therapist	028929	IA
6	225200000X	Physical Therapy Assistant	00881	IA
7	225X00000X	Occupational Therapist	01548	IA
8	225X00000X	Occupational Therapist	01372	IA
9	225X00000X	Occupational Therapist	01616	IA
10	225X00000X	Occupational Therapist	00637	IA
11	235Z00000X	Speech-Language Pathologist	01436	IA
12	261Q00000X	Clinic/Center
13	225100000X	Physical Therapist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	66574	OTHER	IA	WELLMARK BC/BS GROUP #

General Provider Information

NPI Number	:	1376597708
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MILLENNIUM REHAB & CONSULTING, INC.

Provider Business Mailing Address
First Line	:	4725 MERLE HAY RD STE 207
Second Line	:
City	:	DES MOINES
State	:	IA
Zip	:	50322-1983
Country	:	US
Telephone Number	:	515-331-3190
Fax Number	:	515-331-3191

Provider Business Practice Location Address
First Line	:	22 N 27TH ST
Second Line	:
City	:	FORT DODGE
State	:	IA
Zip	:	50501-4331
Country	:	US
Telephone Number	:	515-955-6922
Fax Number	:

Authorized Official
Title or Position	:	COO
Name	:	HOLLY LITTLE
Credential	:
Telephone Number	:	515-331-3190

Provider Enumeration Date	:	05/20/2006
Last Update Date	:	05/28/2025

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