Active NPI
Amanda Nicole Sharp
- Physical Therapist
- Minneapolis, MN
National Provider Identifier
1063744944
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 8981
- Practice address
- 164 Pillsbury Dr SE
Minneapolis, MN 55455-0279 - Phone
- (612) 624-3322
- Fax
- (612) 624-7586
- NPI assigned
- Feb 3, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 11145-24 | WI | |
| Physical Therapist | 225100000X | 8981 | MN | Primary |
Addresses
Primary practice location
164 Pillsbury Dr SE
Minneapolis, MN 55455-0279
Mailing address
420 Delaware St. SE
MMC 388
Minneapols, MN 55455
Phone (612) 626-4601
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11145-24 | WI | MD | Physical Therapist |
| 8981 | MN | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1265155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599696000000",
"number": "1063744944",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "420 DELAWARE ST. SE",
"address_2": "MMC 388",
"city": "MINNEAPOLS",
"state": "MN",
"postal_code": "55455",
"telephone_number": "612-626-4601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "164 PILLSBURY DR SE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554550279",
"telephone_number": "612-624-3322",
"fax_number": "612-624-7586"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHARP",
"first_name": "AMANDA",
"middle_name": "NICOLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-02-03",
"last_updated": "2020-09-10",
"certification_date": "2020-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "11145-24",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": "MN",
"license": "8981",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.