Provider Demographics
NPI:1629356605
Name:STORMS, JIMMIE ROBERT (DPT)
Entity type:Individual
Prefix:DR
First Name:JIMMIE
Middle Name:ROBERT
Last Name:STORMS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 WOODBINE
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47803-1754
Mailing Address - Country:US
Mailing Address - Phone:417-576-7311
Mailing Address - Fax:
Practice Address - Street 1:55 UNITYPOINT WAY STE 70
Practice Address - Street 2:
Practice Address - City:MARSHALLTOWN
Practice Address - State:IA
Practice Address - Zip Code:50158-4749
Practice Address - Country:US
Practice Address - Phone:641-754-6120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-25
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05010613A225100000X
IACP048028T225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist