Active NPI
Amanda Colucci, DPT
- Physical Therapist
- Trinity, FL
National Provider Identifier
1093065203
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT27555
- Practice address
- 2433 Country Place Blvd
BLDG B
Trinity, FL 34655-1163 - Phone
- (813) 844-8200
- NPI assigned
- Sep 14, 2012
- Last updated
- Jun 11, 2021
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT27555 | FL | Primary |
Addresses
Primary practice location
2433 Country Place Blvd
BLDG B
Trinity, FL 34655-1163
Mailing address
2433 Country Place Blvd
BLDG B
Trinity, FL 34655-1163
Phone (813) 844-8200
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | awagner84426@direct.tgh.org |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tampa General Hospital | Current | Accepting new patients |
Networks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
Interoperability endpoints
- https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Acute Care Hospital
- Tampa, FL
- NPI 1124558929
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1347580800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623369600000",
"number": "1093065203",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2433 COUNTRY PLACE BLVD",
"address_2": "BLDG B",
"city": "TRINITY",
"state": "FL",
"postal_code": "346551163",
"telephone_number": "813-844-8200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2433 COUNTRY PLACE BLVD",
"address_2": "BLDG B",
"city": "TRINITY",
"state": "FL",
"postal_code": "346551163",
"telephone_number": "813-844-8200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLUCCI",
"first_name": "AMANDA",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-09-14",
"last_updated": "2021-06-11",
"certification_date": "2021-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT27555",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "awagner84426@direct.tgh.org",
"affiliation": "N",
"address_1": "2433 Country Place Blvd",
"address_2": "Bldg B",
"city": "Trinity",
"state": "FL",
"country_code": "US",
"postal_code": "346551163",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Trinity, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.