Active NPI
Amy Patricia Dunckel, PT
- Physical Therapist
- Lebanon, MO
National Provider Identifier
1003023664
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2002022527
- Practice address
- 331 Hospital Dr
Suite D
Lebanon, MO 65536-9217 - Phone
- (417) 533-6315
- NPI assigned
- May 16, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2002022527 | MO | Primary |
Addresses
Primary practice location
331 Hospital Dr
Suite D
Lebanon, MO 65536-9217
Mailing address
337 Tulane St
Lebanon, MO 65536-4351
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2002022527 | MO | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179273600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1003023664",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "337 TULANE ST",
"city": "LEBANON",
"state": "MO",
"postal_code": "655364351"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "331 HOSPITAL DR",
"address_2": "SUITE D",
"city": "LEBANON",
"state": "MO",
"postal_code": "655369217",
"telephone_number": "417-533-6315"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUNCKEL",
"first_name": "AMY",
"middle_name": "PATRICIA",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MO",
"license": "2002022527",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lebanon, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.